Provider Demographics
NPI:1083836787
Name:BETTINA ZATUCHNI MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:BETTINA ZATUCHNI MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZATUCHNI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-251-1010
Mailing Address - Street 1:5565 W LAS POSITAS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-5806
Mailing Address - Country:US
Mailing Address - Phone:925-251-1010
Mailing Address - Fax:925-251-1017
Practice Address - Street 1:5565 W LAS POSITAS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-5806
Practice Address - Country:US
Practice Address - Phone:925-251-1010
Practice Address - Fax:925-251-1017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G865420Medicare PIN
CAZZZ26379ZMedicare PIN
CAF30163Medicare UPIN