Provider Demographics
NPI:1548844715
Name:REYNARD, ZACHARY JOSEPH (OD)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:JOSEPH
Last Name:REYNARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 STATE ST STE 7
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2799
Mailing Address - Country:US
Mailing Address - Phone:805-899-1240
Mailing Address - Fax:205-934-6755
Practice Address - Street 1:1114 STATE ST STE 7
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2799
Practice Address - Country:US
Practice Address - Phone:805-899-1240
Practice Address - Fax:805-966-5840
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-12
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALT-251-TA-C16152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist