Provider Demographics
NPI:1508938887
Name:ZEVIN, BARRY DAVID (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:DAVID
Last Name:ZEVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 LECH WALESA
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-4506
Mailing Address - Country:US
Mailing Address - Phone:415-355-7400
Mailing Address - Fax:415-355-7407
Practice Address - Street 1:50 LECH WALESA
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4506
Practice Address - Country:US
Practice Address - Phone:415-355-7400
Practice Address - Fax:415-355-7407
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG71721207R00000X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF46154Medicare UPIN