Healthcare Provider Details

I. General information

NPI: 1528095551
Provider Name (Legal Business Name): JOHN J ZIOMEK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 EYE ST
BAKERSFIELD CA
93301-2006
US

IV. Provider business mailing address

227 TRAFALGAR LN
SAN CLEMENTE CA
92672-5482
US

V. Phone/Fax

Practice location:
  • Phone: 661-395-3000
  • Fax:
Mailing address:
  • Phone: 661-378-6410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA43534
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: