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General NPI Number Information
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NPI Number | 1487189254
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Entity Type | Organization
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Legal Business Name | YALDO EYE CENTERS PC
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Dates
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Enumeration Date | 04/28/2017
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Last Update Date | 04/28/2017
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Provider Practice Location Address
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Address Line | 31535 FORD RD
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City | GARDEN CITY
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State | MI
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Zip | 48135-1821
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Country | US
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Telephone | 313-278-4540
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Fax | 313-278-4541
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Provider Business Mailing Address
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Address Line | 28501 ORCHARD LAKE RD
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-2951
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Country | US
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Telephone | 248-553-9800
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAZIN YALDO
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Credential | M.D.
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Telephone | 313-278-4540
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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 | 4301051955
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License Number State | MI
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