Provider Demographics
NPI:1669646170
Name:VERA, ZAKA UDDIN (MD)
Entity Type:Individual
Prefix:
First Name:ZAKA
Middle Name:UDDIN
Last Name:VERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ZAKA
Other - Middle Name:UDDIN
Other - Last Name:VERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:200 OCEANGATE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4302
Mailing Address - Country:US
Mailing Address - Phone:916-399-1100
Mailing Address - Fax:877-860-2397
Practice Address - Street 1:7215 55TH STREET
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2601
Practice Address - Country:US
Practice Address - Phone:916-399-1100
Practice Address - Fax:877-860-2397
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAFE25256207RC0000X
CAA25256207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP01222618/ DS9933OtherRAILROAD MEDICARE-CITRUS HEIGHTS, 55TH ST.
CA1669646170Medicaid
CA1669646170OtherMEDI-CAL
CAP01222618/ DS9933OtherRAILROAD MEDICARE-CITRUS HEIGHTS, 55TH ST.
CA1669646170Medicaid
CADG834YMedicare PIN