Healthcare Provider Details

I. General information

NPI: 1336206804
Provider Name (Legal Business Name): REGINA ZOPF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. REGINA LENABURG

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 11/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 PENNSYLVANIA AVE NW STE W WEST END OB GYN DEPARTMENT
WASHINGTON DC
20037-3227
US

IV. Provider business mailing address

2101 E JEFFERSON ST KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE MD
20852-4908
US

V. Phone/Fax

Practice location:
  • Phone: 202-872-7000
  • Fax:
Mailing address:
  • Phone: 301-816-2424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number222063
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD037207
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD64679
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101250231
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: