Healthcare Provider Details

I. General information

NPI: 1972146694
Provider Name (Legal Business Name): ZIPONGO HEALTH PROVIDER GROUP P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2019
Last Update Date: 08/22/2025
Certification Date: 08/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 PACIFIC AVE FL 4
SAN FRANCISCO CA
94133-4685
US

IV. Provider business mailing address

3041 EAST STREET PBM 1292
CONCORD CA
94520
US

V. Phone/Fax

Practice location:
  • Phone: 415-800-2311
  • Fax:
Mailing address:
  • Phone: 415-800-2311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: DAVID ASHLEY
Title or Position: PC OWNER
Credential: M.D.
Phone: 401-529-7344