Provider Demographics
NPI:1710561865
Name:J PETER ZEGARRA MD INC
Entity Type:Organization
Organization Name:J PETER ZEGARRA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:J PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEGARRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-923-0620
Mailing Address - Street 1:87 SCRIPPS DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6318
Mailing Address - Country:US
Mailing Address - Phone:916-923-0620
Mailing Address - Fax:916-923-0068
Practice Address - Street 1:87 SCRIPPS DR STE 300
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6318
Practice Address - Country:US
Practice Address - Phone:916-923-0620
Practice Address - Fax:916-923-0068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty