Provider Demographics
NPI:1023192960
Name:ZAGONE, ROBIN LEE (MD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LEE
Last Name:ZAGONE
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 1:2576 RENFREW ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-3345
Mailing Address - Country:US
Mailing Address - Phone:707-445-3257
Mailing Address - Fax:707-445-1027
Practice Address - Street 1:780 E WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-8397
Practice Address - Country:US
Practice Address - Phone:707-464-6715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAI11479208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA87575OtherSTATE LISCENCE
CAA87575OtherSTATE LISCENCE
CA00A875750Medicare ID - Type Unspecified