Healthcare Provider Details

I. General information

NPI: 1922170778
Provider Name (Legal Business Name): JOAN Z. KUTSCHBACH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOAN LEE ZIELSKE M.D.

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 04/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 SISTER MARY COLUMBA DR
RED BLUFF CA
96080-4356
US

IV. Provider business mailing address

2450 SISTER MARY COLUMBA DR
RED BLUFF CA
96080-4356
US

V. Phone/Fax

Practice location:
  • Phone: 530-527-0414
  • Fax: 530-528-4423
Mailing address:
  • Phone: 530-527-0414
  • Fax: 530-528-4423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG45803
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: