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NPI Code Detail

MEDICARE: JILL ZUNDELEVICH

MEDICARE:   JILL  ZUNDELEVICH
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
1171100000XAcupuncturist16256CA

General Provider Information

NPI Number : 1821496365
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL ZUNDELEVICH
Provider Business Mailing Address
First Line : 499 SEAPORT CT
Second Line : SUITE 101
City : REDWOOD CITY
State : CA
Zip : 94063-2783
Country : US
Telephone Number : 650-366-4299
Fax Number : 650-261-1067
Provider Business Practice Location Address
First Line : 499 SEAPORT CT
Second Line : SUITE 101
City : REDWOOD CITY
State : CA
Zip : 94063-2783
Country : US
Telephone Number : 650-366-4299
Fax Number : 650-261-1067
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2014
Last Update Date : 12/16/2014

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