Healthcare Provider Details

I. General information

NPI: 1700811742
Provider Name (Legal Business Name): ROBERTO ANGELO ZAPPACOSTA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23845 MCBEAN PKWY
VALENCIA CA
91355-2001
US

IV. Provider business mailing address

PO BOX 661540
ARCADIA CA
91066-1540
US

V. Phone/Fax

Practice location:
  • Phone: 661-253-8112
  • Fax: 661-253-8119
Mailing address:
  • Phone: 626-447-0296
  • Fax: 626-447-6057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA70118
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: