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General NPI Number Information
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NPI Number | 1124005368
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Entity Type | Organization
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Legal Business Name | RP ZUCKER MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 11/25/2020
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Provider Practice Location Address
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Address Line | 155 GLASSON WAY
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City | GRASS VALLEY
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State | CA
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Zip | 95945
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Country | US
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Telephone | 530-241-1473
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Fax | 530-229-3703
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Provider Business Mailing Address
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Address Line | P.O. BOX 496084
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City | REDDING
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State | CA
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Zip | 96049-6084
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Country | US
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Telephone | 530-225-6000
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | ROBERT P ZUCKER
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Credential | MD
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Telephone | 415-595-5568
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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