Provider Demographics
NPI:1528103330
Name:ZACHAR, PAMELA A (MD, MPH)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:ZACHAR
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 BOW MAR DR
Mailing Address - Street 2:
Mailing Address - City:BOW MAR
Mailing Address - State:CO
Mailing Address - Zip Code:80123-1430
Mailing Address - Country:US
Mailing Address - Phone:303-358-9956
Mailing Address - Fax:
Practice Address - Street 1:DOCTORS MEDICAL CENTER
Practice Address - Street 2:1441 FLORIDA AVENUE
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350
Practice Address - Country:US
Practice Address - Phone:209-576-3710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39405208000000X, 2080N0001X
NH13938208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO79802061Medicaid
CAC154180OtherMEDICAL BOARD OF CALIFORNIA