Provider Demographics
NPI:1568637403
Name:ARTHUR ZIMMERMAN, MD, INC
Entity Type:Organization
Organization Name:ARTHUR ZIMMERMAN, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-946-7271
Mailing Address - Street 1:930 E FOOTHILL BLVD
Mailing Address - Street 2:STE. 1
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4051
Mailing Address - Country:US
Mailing Address - Phone:909-946-7271
Mailing Address - Fax:909-949-0831
Practice Address - Street 1:930 E FOOTHILL BLVD
Practice Address - Street 2:STE. 1
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4051
Practice Address - Country:US
Practice Address - Phone:909-946-7271
Practice Address - Fax:909-949-0831
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARTHUR ZIMMERMAN, MD, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG33927174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA45727Medicare UPIN