Provider Demographics
NPI:1841648573
Name:ZAPOTOSKY, ROBERT CORY (PA-C)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:CORY
Last Name:ZAPOTOSKY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:360 SAN MIGUEL DR
Mailing Address - Street 2:STE 501
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7831
Mailing Address - Country:US
Mailing Address - Phone:949-720-1170
Mailing Address - Fax:949-720-1172
Practice Address - Street 1:210 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-4205
Practice Address - Country:US
Practice Address - Phone:626-914-3675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-03
Last Update Date:2017-03-14
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant