Provider Demographics
NPI:1811599046
Name:DELMA F ZARDO OD A PROFESSIONAL OPTOMETRIC CORPORATION
Entity type:Organization
Organization Name:DELMA F ZARDO OD A PROFESSIONAL OPTOMETRIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DELMA
Authorized Official - Middle Name:F
Authorized Official - Last Name:ZARDO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:209-605-0442
Mailing Address - Street 1:2421 KISKA DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-7913
Mailing Address - Country:US
Mailing Address - Phone:209-605-0442
Mailing Address - Fax:
Practice Address - Street 1:810 STANDIFORD AVE STE 4
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-0977
Practice Address - Country:US
Practice Address - Phone:209-524-7870
Practice Address - Fax:209-524-7985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-12
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty