Healthcare Provider Details

I. General information

NPI: 1902782832
Provider Name (Legal Business Name): ZACHARY SCOTT VROBEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2288 THOMAS AVE
SAN DIEGO CA
92109-5630
US

IV. Provider business mailing address

2288 THOMAS AVE
SAN DIEGO CA
92109-5630
US

V. Phone/Fax

Practice location:
  • Phone: 951-438-6512
  • Fax:
Mailing address:
  • Phone: 951-438-6512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: