MEDICARE: ZAUM OPTOMETRIC CORPORATION

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	12030T	CA

General Provider Information

NPI Number	:	1710998646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZAUM OPTOMETRIC CORPORATION

Provider Business Mailing Address
First Line	:	1040 N RENGSTORFF AVE
Second Line	:	SUITE B
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94043-1750
Country	:	US
Telephone Number	:	650-968-3937
Fax Number	:	650-968-4082

Provider Business Practice Location Address
First Line	:	1040 N RENGSTORFF AVE
Second Line	:	SUITE B
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94043-1750
Country	:	US
Telephone Number	:	650-968-3937
Fax Number	:	650-968-4082

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALLISON ZAUM
Credential	:	O.D.
Telephone Number	:	650-968-3937

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	08/22/2020

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Practice Location Address:

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1508080904 — ZAUM OPTOMETRIC CORPORATION
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1316149644 — DR. ORLANDO DEGUIA CALARA D.D.S.
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1871290254 — OLIVIA MILL PT, DPT
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Directions to “ZAUM OPTOMETRIC CORPORATION ” Practice Location

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