Healthcare Provider Details

I. General information

NPI: 1629462254
Provider Name (Legal Business Name): MAYA ZWERDLING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2015
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 FOSTER AVE
ARCATA CA
95521-5986
US

IV. Provider business mailing address

670 9TH ST STE 203
ARCATA CA
95521-6249
US

V. Phone/Fax

Practice location:
  • Phone: 707-826-8610
  • Fax: 707-826-8623
Mailing address:
  • Phone: 707-826-8633
  • Fax: 707-826-8638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA146452
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: