Provider Demographics
NPI:1194591297
Name:ZERO617 LLC
Entity type:Organization
Organization Name:ZERO617 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAY
Authorized Official - Middle Name:SOTILLO
Authorized Official - Last Name:DINGLASAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-770-5999
Mailing Address - Street 1:839 BRIDLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-6748
Mailing Address - Country:US
Mailing Address - Phone:707-770-5999
Mailing Address - Fax:
Practice Address - Street 1:1320 WILLOW PASS RD STE 600
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5292
Practice Address - Country:US
Practice Address - Phone:707-438-8164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care