Healthcare Provider Details

I. General information

NPI: 1184722332
Provider Name (Legal Business Name): SHELDON ZITMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 10/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20555 PROSPECT ROAD
CUPERTINO CA
95014
US

IV. Provider business mailing address

20555 PROSPECT ROAD
CUPERTINO CA
95014
US

V. Phone/Fax

Practice location:
  • Phone: 408-996-9339
  • Fax: 408-996-3550
Mailing address:
  • Phone: 408-996-9339
  • Fax: 408-996-3550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG37930
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: