Healthcare Provider Details
I. General information
NPI: 1790746006
Provider Name (Legal Business Name): SCOTT ADRIAN ZAKALUZNY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/28/2006
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2335 STOCKTON BLVD NAOB, 5TH FLOOR
SACRAMENTO CA
95817-1800
US
IV. Provider business mailing address
2335 STOCKTON BLVD NAOB, 5TH FLOOR
SACRAMENTO CA
95817-1800
US
V. Phone/Fax
- Phone: 916-734-3528
- Fax:
- Phone: 916-734-3528
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | A116254 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | A116254 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | A116254 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: