Provider Demographics
NPI:1063219871
Name:GHITA, ZEPELIN
Entity type:Individual
Prefix:
First Name:ZEPELIN
Middle Name:
Last Name:GHITA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17833 COLUMBIA DR
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94552-1740
Mailing Address - Country:US
Mailing Address - Phone:510-909-1960
Mailing Address - Fax:
Practice Address - Street 1:5195 PROCTOR RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-1422
Practice Address - Country:US
Practice Address - Phone:510-909-1960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility