Healthcare Provider Details

I. General information

NPI: 1639777402
Provider Name (Legal Business Name): JULIAN ARMSTRONG ZOOK RD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 10/14/2020
Certification Date: 10/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 32ND AVE
SAN FRANCISCO CA
94121-3501
US

IV. Provider business mailing address

723 32ND AVE
SAN FRANCISCO CA
94121-3501
US

V. Phone/Fax

Practice location:
  • Phone: 714-399-8211
  • Fax:
Mailing address:
  • Phone: 714-399-8211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: