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Organization
PETER V. HETZNER, O.D.
Active
Organization
PETER V. HETZNER, O.D.
Active
Other names
Lodi Optometry Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER HETZNER O.D. (OWNER)
(209) 368-5352
Entity
Organization
Contact information
Practice address
421 S HAM LN, SUITE B, LODI, CA 95242-3523
(209) 368-5352
(209) 368-5355
Mailing address
421 S HAM LN, SUITE B, LODI, CA 95242-3523
(209) 368-5352
(209) 368-5355
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5692TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0622870001
CIGNA MEDICARE
CA
05
—
SD0056920
—
CA
Enumeration date
10/27/2006
Last updated
02/15/2013
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