Healthcare Provider Details

I. General information

NPI: 1780021766
Provider Name (Legal Business Name): INGEBORG ZOPPOTH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: INGEBORG SCHAFHALTER-ZOPPOTH M.D.

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 01/30/2025
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WEBSTER ST STE 516
SAN FRANCISCO CA
94115-2381
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-2402
  • Fax: 415-369-1292
Mailing address:
  • Phone: 415-600-2402
  • Fax: 415-369-1292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License NumberA122988
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA122988
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: