Healthcare Provider Details

I. General information

NPI: 1568518488
Provider Name (Legal Business Name): DOUGLAS ZIPRICK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 10/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16850 BEAR VALLEY RD
VICTORVILLE CA
92395-5794
US

IV. Provider business mailing address

16850 BEAR VALLEY RD
VICTORVILLE CA
92395-5794
US

V. Phone/Fax

Practice location:
  • Phone: 760-241-8000
  • Fax:
Mailing address:
  • Phone: 760-241-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG19521
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: