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Organization
HERITAGE EYE ASSOCIATES
Active
Organization
HERITAGE EYE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH V MISELIS M.D. (PRESIDENT)
(209) 465-5562
Entity
Organization
Contact information
Practice address
5762 E ACORN CT, STOCKTON, CA 95212-2622
(209) 465-2581
Mailing address
445 W POPLAR ST, STOCKTON, CA 95203-2426
(209) 465-5933
(209) 465-2568
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
G502810
CA
Other
Enumeration date
03/14/2007
Last updated
11/19/2024
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