Provider Demographics
NPI:1275266702
Name:ZEVAH CORP
Entity Type:Organization
Organization Name:ZEVAH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:JC
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:801-867-2002
Mailing Address - Street 1:3308 GLENDORA DR
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-3705
Mailing Address - Country:US
Mailing Address - Phone:801-867-2002
Mailing Address - Fax:
Practice Address - Street 1:1501 TROUSDALE DR STE 115
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4506
Practice Address - Country:US
Practice Address - Phone:801-867-2002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-01
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty