Provider Demographics
NPI:1679929749
Name:THOMAS E ZEWERT MD PHD INC
Entity Type:Organization
Organization Name:THOMAS E ZEWERT MD PHD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:ZEWERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-436-0871
Mailing Address - Street 1:PO BOX 3998
Mailing Address - Street 2:
Mailing Address - City:PINEDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93650-3998
Mailing Address - Country:US
Mailing Address - Phone:559-436-0871
Mailing Address - Fax:559-436-5221
Practice Address - Street 1:337 EL DORADO ST.
Practice Address - Street 2:A-1
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4638
Practice Address - Country:US
Practice Address - Phone:831-644-9800
Practice Address - Fax:559-436-5221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77604208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty