Healthcare Provider Details

I. General information

NPI: 1033141668
Provider Name (Legal Business Name): MARC ZEREY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 03/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 W PUEBLO ST
SANTA BARBARA CA
93105-4355
US

IV. Provider business mailing address

317 W PUEBLO ST
SANTA BARBARA CA
93105-4355
US

V. Phone/Fax

Practice location:
  • Phone: 805-898-3140
  • Fax: 805-898-3117
Mailing address:
  • Phone: 805-898-3140
  • Fax: 805-898-3117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA101096
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: