Provider Demographics
NPI:1689674012
Name:VERZOSA, JOHN DAHUNAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAHUNAN
Last Name:VERZOSA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10725 INTERNATIONAL DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7967
Mailing Address - Country:US
Mailing Address - Phone:916-631-3040
Mailing Address - Fax:530-631-2181
Practice Address - Street 1:10725 INTERNATIONAL DR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-7967
Practice Address - Country:US
Practice Address - Phone:916-631-3040
Practice Address - Fax:530-631-2181
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2021-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA055093207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG62471Medicare UPIN
CA00A550930Medicare ID - Type Unspecified