Provider Demographics
NPI:1528215175
Name:GILBERT Y ZINI, MD, INC.
Entity Type:Organization
Organization Name:GILBERT Y ZINI, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-982-1888
Mailing Address - Street 1:8283 GROVE AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3139
Mailing Address - Country:US
Mailing Address - Phone:909-982-1888
Mailing Address - Fax:909-982-7749
Practice Address - Street 1:8283 GROVE AVE STE 106
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3139
Practice Address - Country:US
Practice Address - Phone:909-982-1888
Practice Address - Fax:909-982-7749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30191207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A301910Medicaid