Provider Demographics
NPI:1619057700
Name:ZILBER, STEPHEN PETER (DACM, LAC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PETER
Last Name:ZILBER
Suffix:
Gender:M
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 GRAVENSTEIN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-4570
Mailing Address - Country:US
Mailing Address - Phone:855-488-1800
Mailing Address - Fax:707-639-1350
Practice Address - Street 1:1020 GRAVENSTEIN AVE STE 100
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-4570
Practice Address - Country:US
Practice Address - Phone:855-488-1800
Practice Address - Fax:707-639-1350
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2021-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5889171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC5889OtherCALIFORNIA ACUPUNCTURE BOARD