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General NPI Number Information
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NPI Number | 1811599046
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Entity Type | Organization
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Legal Business Name | DELMA F ZARDO OD A PROFESSIONAL OPTOMETRIC CORPORATION
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Dates
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Enumeration Date | 11/12/2020
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Last Update Date | 06/22/2021
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Provider Practice Location Address
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Address Line | 810 STANDIFORD AVE STE 4
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City | MODESTO
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State | CA
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Zip | 95350-0977
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Country | US
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Telephone | 209-524-7870
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Fax | 209-524-7985
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Provider Business Mailing Address
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Address Line | 2421 KISKA DR
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City | MODESTO
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State | CA
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Zip | 95355-7913
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Country | US
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Telephone | 209-605-0442
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DELMA F ZARDO
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Credential | OD
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Telephone | 209-605-0442
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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 |
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License Number State |
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