Provider Demographics
NPI:1043233869
Name:VANEK, ZEBA FATIMA (MD)
Entity Type:Individual
Prefix:
First Name:ZEBA
Middle Name:FATIMA
Last Name:VANEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 N CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-6037
Mailing Address - Country:US
Mailing Address - Phone:209-645-4005
Mailing Address - Fax:209-645-6344
Practice Address - Street 1:1805 N CALIFORNIA ST STE 201
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-6032
Practice Address - Country:US
Practice Address - Phone:209-645-4005
Practice Address - Fax:209-645-6344
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA5544442084N0400X
CAA554442084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A554440Medicaid
CAGQ149ZMedicare PIN
CA00A554440Medicaid
CAWA55444AMedicare PIN