Provider Demographics
NPI:1376873927
Name:RONALD A.ZAPPONE, M.D. , INC.
Entity Type:Organization
Organization Name:RONALD A.ZAPPONE, M.D. , INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:ZAPPONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-551-9254
Mailing Address - Street 1:7946 IVANHOE AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4516
Mailing Address - Country:US
Mailing Address - Phone:858-551-9254
Mailing Address - Fax:858-551-9252
Practice Address - Street 1:7946 IVANHOE AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4516
Practice Address - Country:US
Practice Address - Phone:858-551-9254
Practice Address - Fax:858-551-9252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG24562261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G245620-3Medicaid