Healthcare Provider Details
I. General information
NPI: 1215932090
Provider Name (Legal Business Name): MICHAEL ANTHONY ZAPF D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/17/2005
Last Update Date: 01/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
555 MARIN ST STE 290
THOUSAND OAKS CA
91360-4236
US
IV. Provider business mailing address
555 MARIN ST STE 290
THOUSAND OAKS CA
91360-4236
US
V. Phone/Fax
- Phone: 805-497-6979
- Fax: 818-777-7028
- Phone: 805-497-6979
- Fax: 818-777-7028
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | E3322 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: