MEDICARE: BARRY DAVID ZEVIN 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	207R00000X	Internal Medicine Physician	G71721	CA
2	207RA0401X	Addiction Medicine (Internal Medicine) Physician	G71721	CA

General Provider Information

NPI Number	:	1508938887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARRY DAVID ZEVIN M.D.

Provider Business Mailing Address
First Line	:	50 LECH WALESA
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-4506
Country	:	US
Telephone Number	:	415-355-7400
Fax Number	:	415-355-7407

Provider Business Practice Location Address
First Line	:	50 LECH WALESA
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-4506
Country	:	US
Telephone Number	:	415-355-7400
Fax Number	:	415-355-7407

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

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	08/06/2007

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