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General NPI Number Information
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NPI Number | 1073828356
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Entity Type | Organization
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Legal Business Name | WILLIAM E. ZACHOW, D.O. MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/11/2010
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Last Update Date | 08/11/2010
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Provider Practice Location Address
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Address Line | 19747 GREENLEY RD SUITE S-2
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City | SONORA
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State | CA
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Zip | 95370-5998
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Country | US
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Telephone | 602-790-4221
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3009
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City | SONORA
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State | CA
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Zip | 95370-3009
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Country | US
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Telephone | 602-790-4221
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM ZACHOW
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Credential | D.O.
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Telephone | 602-790-4221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A11228
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License Number State | CA
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