Provider Demographics
NPI:1275581886
Name:ZOPFI, JOHN PETER (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PETER
Last Name:ZOPFI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 PENNSYLVANIA AVE
Mailing Address - Street 2:#200
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533
Mailing Address - Country:US
Mailing Address - Phone:707-646-4180
Mailing Address - Fax:707-646-4185
Practice Address - Street 1:1860 PENNSYLVANIA AVE.
Practice Address - Street 2:#200
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533
Practice Address - Country:US
Practice Address - Phone:707-646-4180
Practice Address - Fax:707-646-4185
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5987208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
020A59870Medicare ID - Type Unspecified
E82011Medicare UPIN