1962409193 NPI number — DR. JORGE ZARATE M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962409193 NPI number — DR. JORGE ZARATE M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

ZARATE

Provider First Name:

JORGE

Provider Middle Name:

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

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:

1962409193

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

03/22/2019

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

3241 WESTERN BRANCH BLVD

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

CHESAPEAKE

Provider Business Mailing Address State Name:

VA

Provider Business Mailing Address Postal Code:

23321-5260

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

757-686-3508

Provider Business Mailing Address Fax Number:

757-686-0541

Provider First Line Business Practice Location Address:

830 KEMPSVILLE RD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

NORFOLK

Provider Business Practice Location Address State Name:

VA

Provider Business Practice Location Address Postal Code:

23502-3920

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

757-967-8622

Provider Business Practice Location Address Fax Number:

757-686-0541

Provider Enumeration Date:

07/01/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 174400000X , with the licence number:  0101056807 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 18854 . This is a "SENTARA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
• Identifier: 7085020 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 541910047 . This is a "VA HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".
• Identifier: 89064GX , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
• Identifier: XPY196491 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
• Identifier: 603296 . This is a "BC/BS OF PENNSYLVANIA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 541910047 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 911940000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
• Identifier: 371626 . This is a "MDIPA/MAMSI/OPTIMUM CHOIC" identifier . This identifiers is of the category "OTHER".
• Identifier: 541910047 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 0007085020 . This is a "AETNA US HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 005607876 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
• Identifier: 300044765A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 381726 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".