Provider Demographics
NPI:1073685368
Name:ZMOOS, STEPHEN D (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:D
Last Name:ZMOOS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 FRANKLIN BLVD STE 190
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-1865
Mailing Address - Country:US
Mailing Address - Phone:916-601-8623
Mailing Address - Fax:916-427-1756
Practice Address - Street 1:7000 FRANKLIN BLVD STE 190
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-1865
Practice Address - Country:US
Practice Address - Phone:916-601-8623
Practice Address - Fax:916-427-1756
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15489111N00000X
CADC 15489111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9852438Medicaid
T05784Medicare UPIN
CA9852438Medicaid