Healthcare Provider Details

I. General information

NPI: 1275581886
Provider Name (Legal Business Name): JOHN PETER ZOPFI D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 09/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 PENNSYLVANIA AVE. #200
FAIRFIELD CA
94533
US

IV. Provider business mailing address

1860 PENNSYLVANIA AVE #200
FAIRFIELD CA
94533
US

V. Phone/Fax

Practice location:
  • Phone: 707-646-4180
  • Fax: 707-646-4185
Mailing address:
  • Phone: 707-646-4180
  • Fax: 707-646-4185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number20A5987
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: