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NPI Code Detail

MEDICARE: DR. PETER S. VISENDI O.D.

MEDICARE:  DR. PETER S. VISENDI  O.D.
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
1152W00000XOptometrist5475TCA

General Provider Information

NPI Number : 1518029693
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER S. VISENDI O.D.
Provider Business Mailing Address
First Line : 3464 CAMINO TASSAJARA
Second Line :
City : DANVILLE
State : CA
Zip : 94506-4680
Country : US
Telephone Number : 925-736-4911
Fax Number : 925-736-8272
Provider Business Practice Location Address
First Line : 3464 CAMINO TASSAJARA
Second Line :
City : DANVILLE
State : CA
Zip : 94506-4680
Country : US
Telephone Number : 925-736-4911
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2006
Last Update Date : 07/29/2009

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Directions to “ DR. PETER S. VISENDI O.D.” Practice Location

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