Provider Demographics
NPI:1285143032
Name:ZENITH MEDICAL GROUP - SANTA CRUZ
Entity type:Organization
Organization Name:ZENITH MEDICAL GROUP - SANTA CRUZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-476-8211
Mailing Address - Street 1:200 7TH AVENUE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-4668
Mailing Address - Country:US
Mailing Address - Phone:831-476-8211
Mailing Address - Fax:831-476-8928
Practice Address - Street 1:200 7TH AVENUE
Practice Address - Street 2:SUITE 115
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-4668
Practice Address - Country:US
Practice Address - Phone:831-476-8211
Practice Address - Fax:831-476-8928
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ZENITH MEDICAL GROUP - SANTA CRUZ
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-25
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty