# ZEITER EYE MEDICAL GROUP INC OCULAFACIAL PLASTIC AND RECONSTRUCTIVE SU

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ZEITER EYE MEDICAL GROUP, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1376815605
- **Legal business name:** ZEITER EYE MEDICAL GROUP, INC
- **Authorized official:** DR. JOHN HENRY ZEITER MD (PRESIDENT)
- **Authorized official phone:** (209) 466-5566

## Contact information

- **Practice address:** 1801 E MARCH LN, SUITE A160, STOCKTON, CA 95210-6629
- **Practice address phone:** (209) 466-5566
- **Practice address fax:** (209) 466-0535
- **Mailing address:** 255 E WEBER AVE, STOCKTON, CA 95202-2706
- **Mailing address phone:** (209) 466-5566
- **Mailing address fax:** (209) 466-0535

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 2086S0122X | Plastic and Reconstructive Surgery Physician | — | NULL | — |
| 2086S0122X | Plastic and Reconstructive Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 02/02/2012
- **Last updated:** 05/24/2012