Healthcare Provider Details

I. General information

NPI: 1639585417
Provider Name (Legal Business Name): STEVEN A ZUNIGA JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 07/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 PENNSYLVANIA AVE APT 111
PHILADELPHIA PA
19130-3512
US

IV. Provider business mailing address

2201 PENNSYLVANIA AVE APT 111
PHILADELPHIA PA
19130-3512
US

V. Phone/Fax

Practice location:
  • Phone: 925-580-5450
  • Fax:
Mailing address:
  • Phone: 925-580-5450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMT206734
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: