Healthcare Provider Details

I. General information

NPI: 1235103235
Provider Name (Legal Business Name): JONATHAN RALPH ZUCKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 S PATTERSON AVE
GOLETA CA
93111-2403
US

IV. Provider business mailing address

315 MEIGS RD # A109
SANTA BARBARA CA
93109-1900
US

V. Phone/Fax

Practice location:
  • Phone: 805-967-3411
  • Fax:
Mailing address:
  • Phone: 805-451-4436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA39244
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: