Provider Demographics
NPI:1326218579
Name:DELMA FARIA ZARDO
Entity Type:Organization
Organization Name:DELMA FARIA ZARDO
Other - Org Name:HILMAR OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DELMA
Authorized Official - Middle Name:FARIA
Authorized Official - Last Name:ZARDO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:209-664-2020
Mailing Address - Street 1:19943 AMERICAN AVE
Mailing Address - Street 2:
Mailing Address - City:HILMAR
Mailing Address - State:CA
Mailing Address - Zip Code:95324-9073
Mailing Address - Country:US
Mailing Address - Phone:209-664-2020
Mailing Address - Fax:209-664-3020
Practice Address - Street 1:19943 AMERICAN AVE
Practice Address - Street 2:
Practice Address - City:HILMAR
Practice Address - State:CA
Practice Address - Zip Code:95324-9073
Practice Address - Country:US
Practice Address - Phone:209-664-2020
Practice Address - Fax:209-664-3020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT12678T332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0126780Medicaid
CAV10942Medicare UPIN
CASD0126780Medicare PIN
CA5904210001Medicare NSC