Healthcare Provider Details

I. General information

NPI: 1417981762
Provider Name (Legal Business Name): STEVEN MATHEW ZINDER ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N STATE COLLEGE BLVD CALIFORNIA STATE UNIVERSITY, FULLERTON
FULLERTON CA
92831-3547
US

IV. Provider business mailing address

13220 USF LAUREL DRIVE MDC106
TAMPA FL
33612
US

V. Phone/Fax

Practice location:
  • Phone: 714-278-7671
  • Fax:
Mailing address:
  • Phone: 813-396-9464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: