MEDICARE: ALEJANDRO ZAFFARONI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	G45113	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	00G451132	OTHER	CA	MEDICARE INDIVIDUAL PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316963507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRO ZAFFARONI M.D.

Provider Business Mailing Address
First Line	:	762 ALTOS OAKS DR
Second Line	:
City	:	LOS ALTOS
State	:	CA
Zip	:	94024-5434
Country	:	US
Telephone Number	:	650-948-9123
Fax Number	:	650-948-0563

Provider Business Practice Location Address
First Line	:	762 ALTOS OAKS DR
Second Line	:
City	:	LOS ALTOS
State	:	CA
Zip	:	94024-5434
Country	:	US
Telephone Number	:	650-948-9123
Fax Number	:	650-948-0563

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	06/09/2015

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