Provider Demographics
NPI:1497266449
Name:ZESK, PETE RICHARD
Entity Type:Individual
Prefix:MR
First Name:PETE
Middle Name:RICHARD
Last Name:ZESK
Suffix:
Gender:M
Credentials:
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:BETH
Other - Last Name:MAYERHOFER ZESK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ACQ
Mailing Address - Street 1:28769 GALAXY WAY
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92586-3868
Mailing Address - Country:US
Mailing Address - Phone:951-434-4047
Mailing Address - Fax:
Practice Address - Street 1:28769 GALAXY WAY
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:CA
Practice Address - Zip Code:92586-3868
Practice Address - Country:US
Practice Address - Phone:951-434-4047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAACQ5896333300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies