MEDICARE: DR. MARC ANTHONY ZEPEDA 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	174400000X	Specialist	G422760	CA
2	207V00000X	Obstetrics & Gynecology Physician	P3495	TX

General Provider Information

NPI Number	:	1336100122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARC ANTHONY ZEPEDA M.D.

Provider Business Mailing Address
First Line	:	201 ROCK GLENN CT
Second Line	:
City	:	ALEDO
State	:	TX
Zip	:	76008-6919
Country	:	US
Telephone Number	:	714-743-3041
Fax Number	:	714-771-0249

Provider Business Practice Location Address
First Line	:	201 ROCK GLENN CT
Second Line	:
City	:	ALEDO
State	:	TX
Zip	:	76008-6919
Country	:	US
Telephone Number	:	714-743-3041
Fax Number	:

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

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	02/07/2023

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