Healthcare Provider Details

I. General information

NPI: 1033514054
Provider Name (Legal Business Name): DAVID ZAKIM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2014
Last Update Date: 11/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 MELROSE AVE
MILL VALLEY CA
94941-3437
US

IV. Provider business mailing address

323 MELROSE AVE
MILL VALLEY CA
94941-3437
US

V. Phone/Fax

Practice location:
  • Phone: 415-389-0250
  • Fax:
Mailing address:
  • Phone: 415-389-0250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License NumberG-18391
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: