Healthcare Provider Details

I. General information

NPI: 1174614036
Provider Name (Legal Business Name): ELI S ZINNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 SOUTH PALISADE DRIVE SUITE 104
SANTA MARIA CA
93454-8905
US

IV. Provider business mailing address

116 S PALISADE DR STE 103
SANTA MARIA CA
93454-8904
US

V. Phone/Fax

Practice location:
  • Phone: 805-739-3957
  • Fax: 805-739-3958
Mailing address:
  • Phone: 805-922-8006
  • Fax: 805-922-0184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG89288
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: