Basic Information
| Provider Information | |||||||||
| NPI: | 1306321914 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ZELAYA OPTOMETRY INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2712 W 80TH ST | ||||||||
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| City: | INGLEWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 903051409 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 5822 S VERMONT AVE | ||||||||
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| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900443712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3237812209 | ||||||||
| FaxNumber: | 3235419645 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2018 | ||||||||
| LastUpdateDate: | 09/28/2018 | ||||||||
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| AuthorizedOfficialLastName: | ZELAYA | ||||||||
| AuthorizedOfficialFirstName: | KATYA | ||||||||
| AuthorizedOfficialMiddleName: | SUYIN | ||||||||
| AuthorizedOfficialTitleorPosition: | OPTOMETRIST | ||||||||
| AuthorizedOfficialTelephone: | 3238544682 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | OD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.