Healthcare Provider Details

I. General information

NPI: 1134338825
Provider Name (Legal Business Name): BENJAMIN THOMAS ZAPPIN L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 HANOVER ST
SANTA CRUZ CA
95062-2206
US

IV. Provider business mailing address

823 HANOVER ST
SANTA CRUZ CA
95062-2206
US

V. Phone/Fax

Practice location:
  • Phone: 831-426-4381
  • Fax:
Mailing address:
  • Phone: 831-426-4381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number8933
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: