Provider Demographics
NPI:1184684177
Name:ZUMBRO, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ZUMBRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 LATOUCHE ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4260
Mailing Address - Country:US
Mailing Address - Phone:907-561-1530
Mailing Address - Fax:
Practice Address - Street 1:3500 LATOUCHE ST
Practice Address - Street 2:SUITE 250
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4260
Practice Address - Country:US
Practice Address - Phone:907-561-1530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4585207W00000X
WI32542-020207W00000X
IA34972207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology