Healthcare Provider Details

I. General information

NPI: 1710030424
Provider Name (Legal Business Name): J. S. ZIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JOHN STEPHEN ZIL MD

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8001 BRUCEVILLE RD
SACRAMENTO CA
95823-2329
US

IV. Provider business mailing address

PO BOX 160208
SACRAMENTO CA
95816-0208
US

V. Phone/Fax

Practice location:
  • Phone: 916-288-0300
  • Fax: 916-689-5517
Mailing address:
  • Phone: 916-288-0300
  • Fax: 916-689-5517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG028741
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: