1235220211 NPI number — DR. JOHN CHARLES ZIMMERMAN DPM

Table of content: DR. JOHN CHARLES ZIMMERMAN DPM (NPI 1235220211)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235220211 NPI number — DR. JOHN CHARLES ZIMMERMAN DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZIMMERMAN
Provider First Name:
JOHN
Provider Middle Name:
CHARLES
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
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:
1235220211
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9300 STOCKDALE HWY
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-663-8483
Provider Business Mailing Address Fax Number:
661-663-3095

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9300 STOCKDALE HWY
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-663-8483
Provider Business Practice Location Address Fax Number:
661-663-3095
Provider Enumeration Date:
09/27/2006

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: 213ES0103X , with the licence number:  E3392 , 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: 000E33920 . This is a "BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 480031959 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com