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KAISER PERMANENTE PHYSICIANS CONVICTED AND/OR UNDER INVESTIGATION  OF SEXUAL ASSAULT, PERVERSION, ETC.

This has been mirrored for historical purposes from:

General Billing Coding Information -  Mark B. Zweifach, MD

NPI Number : 1497803381
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK B. ZWEIFACH MD
Provider Business Mailing Address
First Line : 393 E WALNUT ST
Second Line : 3RD FLOOR PHR SYSTEMS
City : PASADENA
State : CA
Zip : 911880001
Country : US
Telephone Number : 0000000000
Fax Number : 0000000000
Provider Business Practice Location Address
First Line : 4405 VANDEVER AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 921203315
Country : US
Telephone Number : 6195285000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 11/29/2007

Detailed Information

NPI Number 1497803381 has the “Individual” type of ownership and has been registered to the following primary business legal name (which is a provider name or healthcare organization name) — MARK B. ZWEIFACH MD.
Records indicate that the provider gender is “Male”.
The enumeration date of this NPI Number is 01/08/2007.
NPI Numer information was last updated at 11/29/2007.

The provider is physically located (Business Practice Location) at:

4405 VANDEVER AVE
SAN DIEGO , CA
921203315
US

The provider can be reached at his practice location using the following numbers:

Phone 6195285000
Fax

The provider's official mailing address is:

393 E WALNUT ST
3RD FLOOR PHR SYSTEMS
PASADENA , CA
911880001
US

The contact numbers associated with the mailing address are:

Phone 0000000000
Fax 0000000000

The authorized official registered with the “1497803381” NPI Number is .

The authorized official title (position) is .

You can reach the authorized official at the following phone number .

Scope of Practice

The following information about the speciality of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1 2084P0800X Psychiatry G48626 CA

Legacy Identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 00G486260 MEDICAID CA
2 A51120 MEDICARE UPIN