MEDICARE: MICHELE L ZUCKER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	35.084839	OH
2	2080A0000X	Pediatric Adolescent Medicine Physician	312011-01	NY
3	2080A0000X	Pediatric Adolescent Medicine Physician	T4095	TX
4	2080A0000X	Pediatric Adolescent Medicine Physician	MD61181970	WA
5	2080A0000X	Pediatric Adolescent Medicine Physician	DR.0067384	CO
6	2080A0000X	Pediatric Adolescent Medicine Physician	MD432542	PA
7	2080A0000X	Pediatric Adolescent Medicine Physician	35.084839	OH
8	2080A0000X	Pediatric Adolescent Medicine Physician	036.149430	CA
9	2080A0000X	Pediatric Adolescent Medicine Physician	036.149430	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083663538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE L ZUCKER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 131747
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92013-1747
Country	:	US
Telephone Number	:	193-506-2906
Fax Number	:	267-425-9299

Provider Business Practice Location Address
First Line	:	2659 STATE ST STE 100
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-1627
Country	:	US
Telephone Number	:	619-350-6290
Fax Number	:	619-436-4739

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	11/03/2023

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Directions to “ MICHELE L ZUCKER M.D.” Practice Location

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