Healthcare Provider Details

I. General information

NPI: 1316963507
Provider Name (Legal Business Name): ALEJANDRO ZAFFARONI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 06/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

762 ALTOS OAKS DR
LOS ALTOS CA
94024-5434
US

IV. Provider business mailing address

762 ALTOS OAKS DR
LOS ALTOS CA
94024-5434
US

V. Phone/Fax

Practice location:
  • Phone: 650-948-9123
  • Fax: 650-948-0563
Mailing address:
  • Phone: 650-948-9123
  • Fax: 650-948-0563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberG45113
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: