1699896381 NPI number — DR. RICHARD FERDINAND ZIPF MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699896381 NPI number — DR. RICHARD FERDINAND ZIPF MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZIPF
Provider First Name:
RICHARD
Provider Middle Name:
FERDINAND
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699896381
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

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

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4925 J STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95819-3828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-487-9198
Provider Business Practice Location Address Fax Number:
916-481-1615
Provider Enumeration Date:
04/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  G11397 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 169989381 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 195715900 . This is a "DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00G113970 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 942209655 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 958190000 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00G113971 . This is a "MEDICARE INDIVIDUAL PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 180025520 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 942209655958190000 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00G113970 . This is a "INDIVIDUAL BILLING #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: CGP128485 . This is a "CCS - CALIF STATE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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