MEDICARE: J PIETRANTONIO OD INC

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	10400T	CA

General Provider Information

NPI Number	:	1346442043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J PIETRANTONIO OD INC

Provider Business Mailing Address
First Line	:	233 N SANTA CRUZ AVE
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95030-7206
Country	:	US
Telephone Number	:	408-354-9310
Fax Number	:	408-354-5889

Provider Business Practice Location Address
First Line	:	233 N SANTA CRUZ AVE
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95030-7206
Country	:	US
Telephone Number	:	408-354-9310
Fax Number	:	408-354-5889

Authorized Official
Title or Position	:	DOCTOR OWNER
Name	:	DR. JIM PIETRANTONIO
Credential	:	DO
Telephone Number	:	408-354-9310

Provider Enumeration Date	:	06/04/2007
Last Update Date	:	09/10/2009

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