Provider Demographics
NPI:1174169767
Name:ZUNIGA OPTICAL, INC
Entity type:Organization
Organization Name:ZUNIGA OPTICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTER DISPENSING OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ESTHER
Authorized Official - Last Name:ZUNIGA VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:ABOC/RDO
Authorized Official - Phone:707-332-0507
Mailing Address - Street 1:PO BOX 6614
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94581-1614
Mailing Address - Country:US
Mailing Address - Phone:707-332-0507
Mailing Address - Fax:
Practice Address - Street 1:770 MAIN ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-3381
Practice Address - Country:US
Practice Address - Phone:707-332-0507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty