Provider Demographics
NPI:1790186518
Name:STEVEN D. ZELKO, MD INC.
Entity Type:Organization
Organization Name:STEVEN D. ZELKO, MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:ZELKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-682-2618
Mailing Address - Street 1:1933 CLIFF DR STE 29
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93109-1589
Mailing Address - Country:US
Mailing Address - Phone:805-682-2618
Mailing Address - Fax:805-682-0125
Practice Address - Street 1:1933 CLIFF DR STE 29
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93109-1589
Practice Address - Country:US
Practice Address - Phone:805-682-2618
Practice Address - Fax:805-682-0125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11178TG152W00000X
CAG68357207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW00G683570Medicaid
CAW00G683570Medicaid