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General NPI Number Information
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NPI Number | 1427254168
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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 | 06/21/2007
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Last Update Date | 09/09/2009
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Provider Practice Location Address
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Address Line | 1630 W YOSEMITE AVE SUITE 3
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City | MANTECA
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State | CA
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Zip | 95337-5191
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Country | US
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Telephone | 209-239-3880
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Fax |
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Provider Business Mailing Address
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Address Line | 255 E WEBER AVE
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City | STOCKTON
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State | CA
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Zip | 95202-2706
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Country | US
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Telephone | 209-466-5566
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | JOHN 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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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