Provider Demographics
NPI:1720320872
Name:OAKEY, ZACKERY (MD)
Entity Type:Individual
Prefix:DR
First Name:ZACKERY
Middle Name:
Last Name:OAKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BAYLEAF LN
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-1262
Mailing Address - Country:US
Mailing Address - Phone:949-478-4770
Mailing Address - Fax:
Practice Address - Street 1:114 PACIFICA STE 390
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3335
Practice Address - Country:US
Practice Address - Phone:949-868-1044
Practice Address - Fax:949-239-1043
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI67335207W00000X
CAA134573207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA100114312Medicaid