Healthcare Provider Details

I. General information

NPI: 1487933719
Provider Name (Legal Business Name): ZACHARY JOHN PECKLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2767 OLIVE HWY
OROVILLE CA
95966-6118
US

IV. Provider business mailing address

1015 WALNUT ST. SUITE 620 CURTIS
PHILADELPHIA PA
19107
US

V. Phone/Fax

Practice location:
  • Phone: 530-533-8500
  • Fax: 530-532-8370
Mailing address:
  • Phone: 215-955-1170
  • Fax: 215-955-2878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD445027
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA164058
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: