# HERITAGE EYE ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972636397
- **Authorized official:** DR. KENNETH V MISELIS M.D. (PRESIDENT)
- **Authorized official phone:** (209) 465-5562

## Contact information

- **Practice address:** 5762 E ACORN CT, STOCKTON, CA 95212-2622
- **Practice address phone:** (209) 465-2581
- **Mailing address:** 445 W POPLAR ST, STOCKTON, CA 95203-2426
- **Mailing address phone:** (209) 465-5933
- **Mailing address fax:** (209) 465-2568

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | G502810 | CA | Yes |

## Other

- **Enumeration date:** 03/14/2007
- **Last updated:** 11/19/2024