Provider Demographics
NPI:1336215128
Name:ZISMAN, FRANK (OD, PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:ZISMAN
Suffix:
Gender:M
Credentials:OD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 OBSIDIAN WAY
Mailing Address - Street 2:
Mailing Address - City:HERCULES
Mailing Address - State:CA
Mailing Address - Zip Code:94547-1724
Mailing Address - Country:US
Mailing Address - Phone:510-799-3335
Mailing Address - Fax:
Practice Address - Street 1:7300 WYNDHAM DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-4913
Practice Address - Country:US
Practice Address - Phone:916-525-6422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5802TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1972113Medicaid
CAYYY49764YMedicare ID - Type Unspecified
CA1072500001Medicare ID - Type UnspecifiedCIGNA
CA4100379135199Medicare ID - Type UnspecifiedRAIL ROAD MEDICARE
CA1972113Medicaid