Provider Demographics
NPI:1093749491
Name:VERNE, ALLEN ZACHARY (MD)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:ZACHARY
Last Name:VERNE
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 1:2219 BUCHANAN ROAD
Mailing Address - Street 2:SUITE #6
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-4200
Mailing Address - Country:US
Mailing Address - Phone:925-522-8850
Mailing Address - Fax:925-522-8851
Practice Address - Street 1:122 LA CASA VIA
Practice Address - Street 2:SUITE #223
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3014
Practice Address - Country:US
Practice Address - Phone:925-943-6800
Practice Address - Fax:925-943-6880
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG29473207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G294730Medicaid
CABW138ZMedicare PIN
CA00G294730Medicare PIN
CA00G294730Medicaid