MEDICARE: JENNIFER ZHAO OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPT35397-TLG	CA

General Provider Information

NPI Number	:	1245927748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ZHAO OD

Provider Business Mailing Address
First Line	:	3743 FAIRLANDS DR
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94588-3418
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5575 W LAS POSITAS BLVD STE 240
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94588-5803
Country	:	US
Telephone Number	:	925-460-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2023
Last Update Date	:	10/18/2024

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