Provider Demographics
NPI:1609012566
Name:ASFOUR-GRIFONI, ZEINA (MPT)
Entity Type:Individual
Prefix:
First Name:ZEINA
Middle Name:
Last Name:ASFOUR-GRIFONI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 TAMAL PLZ
Mailing Address - Street 2:SUITE 507
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1151
Mailing Address - Country:US
Mailing Address - Phone:415-924-2228
Mailing Address - Fax:
Practice Address - Street 1:500 TAMAL PLZ
Practice Address - Street 2:SUITE 507
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1151
Practice Address - Country:US
Practice Address - Phone:415-924-2228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-24
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT28427225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ45394Medicare UPIN
CA0PT284271Medicare PIN