Provider Demographics
NPI:1225885692
Name:DAVID ZUCKER, O.D., A PROFESSIONAL OPTOMETRIC CORPORATION
Entity type:Organization
Organization Name:DAVID ZUCKER, O.D., A PROFESSIONAL OPTOMETRIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-899-1240
Mailing Address - Street 1:1114 STATE ST STE 7
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2799
Mailing Address - Country:US
Mailing Address - Phone:805-899-1240
Mailing Address - Fax:805-966-5840
Practice Address - Street 1:1114 STATE ST STE 7
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2799
Practice Address - Country:US
Practice Address - Phone:805-899-1240
Practice Address - Fax:805-966-5840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty