Provider Demographics
NPI:1750471777
Name:ZIPPE, CRAIG DONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:DONALD
Last Name:ZIPPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 COLORADO AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-2710
Mailing Address - Country:US
Mailing Address - Phone:209-647-3950
Mailing Address - Fax:209-632-3021
Practice Address - Street 1:1801 COLORADO AVE STE 250
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2710
Practice Address - Country:US
Practice Address - Phone:209-647-3950
Practice Address - Fax:209-632-3021
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-067297208800000X
OH35067297Z208800000X
CAG164376208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0983717Medicaid
OHZI7346071Medicare PIN
OH0983717Medicaid
OH0766581Medicare PIN