Provider Demographics
NPI:1487029799
Name:ZAMORA OPTOMETRY INC
Entity Type:Organization
Organization Name:ZAMORA OPTOMETRY INC
Other - Org Name:MONTEBELLO OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIACRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:323-888-9111
Mailing Address - Street 1:2421 W BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-2305
Mailing Address - Country:US
Mailing Address - Phone:323-888-9111
Mailing Address - Fax:323-888-0612
Practice Address - Street 1:2421 W BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-2305
Practice Address - Country:US
Practice Address - Phone:323-888-9111
Practice Address - Fax:323-888-0612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14293152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty