MEDICARE: LOUIS RUSSO ZWERLING

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	2085R0202X	Diagnostic Radiology Physician	AFE22578	CA

General Provider Information

NPI Number	:	1215179775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIS RUSSO ZWERLING

Provider Business Mailing Address
First Line	:	1020 LAURENT ST
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95060-2506
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 LAURENT ST
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95060-2506
Country	:	US
Telephone Number	:	831-426-4866
Fax Number	:

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

Provider Enumeration Date	:	03/30/2009
Last Update Date	:	03/30/2009

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Directions to “ LOUIS RUSSO ZWERLING ” Practice Location

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