Provider Demographics
NPI:1033614730
Name:ZEOLLA, LUKE (PA)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:ZEOLLA
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 1:440 AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-3302
Mailing Address - Country:US
Mailing Address - Phone:831-757-8689
Mailing Address - Fax:831-757-7038
Practice Address - Street 1:950 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93905-2150
Practice Address - Country:US
Practice Address - Phone:831-757-6237
Practice Address - Fax:831-757-8458
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0008047363AM0700X
CA55378363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical