MEDICARE: DR. JOHN JOSEPH ZANE M.D.,J.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	133NN1002X	Nutrition Education Nutritionist	101YMO88OOX	CA
2	103TB0200X	Cognitive & Behavioral Psychologist

General Provider Information

NPI Number	:	1851618656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN JOSEPH ZANE M.D.,J.D.

Provider Business Mailing Address
First Line	:	78509 PALM TREE AVE
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-1853
Country	:	US
Telephone Number	:	760-832-5794
Fax Number	:

Provider Business Practice Location Address
First Line	:	78509 PALM TREE AVE
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-1853
Country	:	US
Telephone Number	:	760-832-5794
Fax Number	:

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

Provider Enumeration Date	:	05/03/2010
Last Update Date	:	05/21/2010

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