MEDICARE: DR. RICHARD FERDINAND ZIPF MD

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	207W00000X	Ophthalmology Physician	G11397	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	00G113971	OTHER		MEDICARE INDIVIDUAL PTAN
7	180025520	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	169989381	OTHER		NPI
2	195715900	OTHER		DEPT OF LABOR
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	942209655	OTHER		TRICARE
5	958190000	OTHER		TRICARE
8	942209655958190000	OTHER		TRICARE
9	00G113970	OTHER	CA	INDIVIDUAL BILLING #
10	CGP128485	OTHER	CA	CCS - CALIF STATE

General Provider Information

NPI Number	:	1699896381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD FERDINAND ZIPF MD

Provider Business Mailing Address
First Line	:	4925 J STREET
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-3828
Country	:	US
Telephone Number	:	916-487-9198
Fax Number	:	916-481-1615

Provider Business Practice Location Address
First Line	:	4925 J STREET
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-3828
Country	:	US
Telephone Number	:	916-487-9198
Fax Number	:	916-481-1615

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

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	10/16/2008

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