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General NPI Number Information
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NPI Number | 1316763238
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Entity Type | Individual
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Provider Name | NICHOLAS ZUSMAN
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Gender | Male
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 2813 MISSION ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-3907
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Country | US
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Telephone | 949-677-3047
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Fax |
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Provider Business Mailing Address
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Address Line | 1 TURNBERRY DR
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-9202
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 111592
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License Number State | CA
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