Healthcare Provider Details

I. General information

NPI: 1710561865
Provider Name (Legal Business Name): J PETER ZEGARRA MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 05/05/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 SCRIPPS DR STE 300
SACRAMENTO CA
95825-6318
US

IV. Provider business mailing address

87 SCRIPPS DR STE 300
SACRAMENTO CA
95825-6318
US

V. Phone/Fax

Practice location:
  • Phone: 916-923-0620
  • Fax: 916-923-0068
Mailing address:
  • Phone: 916-923-0620
  • Fax: 916-923-0068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: J PETER ZEGARRA
Title or Position: PROVIDER
Credential: MD
Phone: 916-923-0620