Provider Demographics
NPI:1699896381
Name:ZIPF, RICHARD FERDINAND (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:FERDINAND
Last Name:ZIPF
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4925 J STREET
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3828
Mailing Address - Country:US
Mailing Address - Phone:916-487-9198
Mailing Address - Fax:916-481-1615
Practice Address - Street 1:4925 J STREET
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3828
Practice Address - Country:US
Practice Address - Phone:916-487-9198
Practice Address - Fax:916-481-1615
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG11397207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
169989381OtherNPI
195715900OtherDEPT OF LABOR
CA00G113970Medicaid
942209655OtherTRICARE
958190000OtherTRICARE
00G113971OtherMEDICARE INDIVIDUAL PTAN
180025520OtherRAILROAD MEDICARE
942209655958190000OtherTRICARE
CA00G113970OtherINDIVIDUAL BILLING #
CACGP128485OtherCCS - CALIF STATE
CACGP128485OtherCCS - CALIF STATE
942209655OtherTRICARE