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General NPI Number Information
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NPI Number | 1275608218
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Entity Type | Organization
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Legal Business Name | ZEITER EYE MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 10/27/2011
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Provider Practice Location Address
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Address Line | 117 N SAN JOAQUIN ST
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City | STOCKTON
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State | CA
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Zip | 95202-2406
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Country | US
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Telephone | 209-466-5566
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Fax | 209-464-6950
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Provider Business Mailing Address
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Address Line | 117 N SAN JOAQUIN ST
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City | STOCKTON
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State | CA
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Zip | 95202-2406
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Country | US
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Telephone | 209-466-5566
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Fax | 209-464-6950
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN H ZEITER
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Credential | M.D.
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Telephone | 209-466-5566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | 030000483
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License Number State | CA
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