Provider Demographics
NPI:1497245187
Name:JOSEPH A ZAMMUTO
Entity Type:Organization
Organization Name:JOSEPH A ZAMMUTO
Other - Org Name:JOSEPH A ZAMMUTO DO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZAMMUTO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:650-996-8584
Mailing Address - Street 1:2120 AVY AVE
Mailing Address - Street 2:P O BOX 7068
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-6518
Mailing Address - Country:US
Mailing Address - Phone:650-996-8584
Mailing Address - Fax:800-756-8714
Practice Address - Street 1:213 CREST RD
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:CA
Practice Address - Zip Code:94062
Practice Address - Country:US
Practice Address - Phone:650-996-8584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-17
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A497207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty