Provider Demographics
NPI:1194747014
Name:ZARINS, RAYMOND KENNETH (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:KENNETH
Last Name:ZARINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 PLUM LN
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-4532
Mailing Address - Country:US
Mailing Address - Phone:909-335-2323
Mailing Address - Fax:909-307-8643
Practice Address - Street 1:1680 PLUM LN
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-4532
Practice Address - Country:US
Practice Address - Phone:909-335-2323
Practice Address - Fax:909-307-8643
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34998207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8849930Medicaid
A27651Medicare UPIN
CA8849930Medicaid