Provider Demographics
NPI:1316963507
Name:ZAFFARONI, ALEJANDRO (MD)
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:ZAFFARONI
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 1:762 ALTOS OAKS DR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-5434
Mailing Address - Country:US
Mailing Address - Phone:650-948-9123
Mailing Address - Fax:650-948-0563
Practice Address - Street 1:762 ALTOS OAKS DR
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-5434
Practice Address - Country:US
Practice Address - Phone:650-948-9123
Practice Address - Fax:650-948-0563
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG45113207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G451130Medicaid
CA00G451132OtherMEDICARE INDIVIDUAL PIN
CAZZZ06467ZMedicare PIN
CAA89811Medicare UPIN