Provider Demographics
NPI:1649212770
Name:ZIPPERER, JOHN D JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:ZIPPERER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:DOUGLAS
Other - Last Name:ESTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:520 S SEPULVEDA BLVD STE 402
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-3537
Mailing Address - Country:US
Mailing Address - Phone:424-330-2838
Mailing Address - Fax:424-330-2838
Practice Address - Street 1:520 S SEPULVEDA BLVD STE 402
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-3537
Practice Address - Country:US
Practice Address - Phone:424-330-2838
Practice Address - Fax:424-330-2838
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK6922207RA0401X, 208VP0014X
CAC145502207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H52875Medicare UPIN