Healthcare Provider Details

I. General information

NPI: 1144806084
Provider Name (Legal Business Name): JONATHAN ZUCHOWSKI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6050 HELLYER AVE STE 125
SAN JOSE CA
95138-1043
US

IV. Provider business mailing address

6050 HELLYER AVE STE 125
SAN JOSE CA
95138-1043
US

V. Phone/Fax

Practice location:
  • Phone: 408-476-9199
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number35042
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: