Provider Demographics
NPI:1225195928
Name:ZSIGMOND, GYULA LASZLO (MD)
Entity Type:Individual
Prefix:
First Name:GYULA
Middle Name:LASZLO
Last Name:ZSIGMOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JULIUS
Other - Middle Name:LASZLO
Other - Last Name:ZSIGMOND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:901 CAMPUS DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4900
Mailing Address - Country:US
Mailing Address - Phone:650-994-0114
Mailing Address - Fax:650-994-8502
Practice Address - Street 1:901 CAMPUS DR
Practice Address - Street 2:SUITE 303
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-4900
Practice Address - Country:US
Practice Address - Phone:650-994-0114
Practice Address - Fax:650-994-8502
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37600208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6091017Medicaid
CA00A376000Medicare ID - Type Unspecified
CAC03968Medicare UPIN