Provider Demographics
NPI:1295825073
Name:ZATUCHNI, BETTINA (MD)
Entity Type:Individual
Prefix:
First Name:BETTINA
Middle Name:
Last Name:ZATUCHNI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5565 W LAS POSITAS BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588
Mailing Address - Country:US
Mailing Address - Phone:925-251-1010
Mailing Address - Fax:925-251-1017
Practice Address - Street 1:5565 W LAS POSITAS BLVD
Practice Address - Street 2:STE 200
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588
Practice Address - Country:US
Practice Address - Phone:925-251-1010
Practice Address - Fax:925-251-1017
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG86542207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G865420Medicaid
F30163Medicare UPIN
CA00G865420Medicare ID - Type Unspecified