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General NPI Number Information
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NPI Number | 1346442043
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Entity Type | Organization
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Legal Business Name | J PIETRANTONIO OD INC
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 09/10/2009
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Provider Practice Location Address
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Address Line | 233 N SANTA CRUZ AVE
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City | LOS GATOS
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State | CA
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Zip | 95030-7206
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Country | US
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Telephone | 408-354-9310
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Fax | 408-354-5889
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Provider Business Mailing Address
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Address Line | 233 N SANTA CRUZ AVE
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City | LOS GATOS
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State | CA
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Zip | 95030-7206
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Country | US
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Telephone | 408-354-9310
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Fax | 408-354-5889
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Authorized Official
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Title or Position | DOCTOR OWNER
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Name | DR. JIM PIETRANTONIO
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Credential | DO
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Telephone | 408-354-9310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 10400T
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License Number State | CA
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