Provider Demographics
NPI:1699986935
Name:LADNER, ZACHARY (PA)
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:
Last Name:LADNER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 JOHN MUIR PKWY
Mailing Address - Street 2:STE 285
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5193
Mailing Address - Country:US
Mailing Address - Phone:925-513-2646
Mailing Address - Fax:925-513-2650
Practice Address - Street 1:350 JOHN MUIR PKWY
Practice Address - Street 2:SUITE 285
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513
Practice Address - Country:US
Practice Address - Phone:925-513-2646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical