Provider Demographics
NPI:1962729004
Name:ZUMSTEG, ZACHARY STEPHAN (MD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:STEPHAN
Last Name:ZUMSTEG
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 1:1417 VETERAN AVE.
Mailing Address - Street 2:APT 109
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-4856
Mailing Address - Country:US
Mailing Address - Phone:305-527-1544
Mailing Address - Fax:
Practice Address - Street 1:14445 OLIVE VIEW DR.
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342
Practice Address - Country:US
Practice Address - Phone:818-364-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA1382722085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program