Healthcare Provider Details

I. General information

NPI: 1437449089
Provider Name (Legal Business Name): MATTHEW ZINTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2011
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE BOX 0110
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

5065 COVERED BRIDGE WAY
EL DORADO HILLS CA
95762-5009
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-6245
  • Fax:
Mailing address:
  • Phone: 314-740-0740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA124824
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberA124824
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: