Provider Demographics
NPI:1801197504
Name:ZIDER, ALEXANDER DAVID (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:DAVID
Last Name:ZIDER
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 1:1750 EL CAMINO REAL STE 307
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3216
Mailing Address - Country:US
Mailing Address - Phone:650-697-7079
Mailing Address - Fax:650-697-5845
Practice Address - Street 1:1750 EL CAMINO REAL STE 307
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3216
Practice Address - Country:US
Practice Address - Phone:650-697-7079
Practice Address - Fax:650-697-5845
Is Sole Proprietor?:No
Enumeration Date:2010-11-11
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA119792207R00000X, 207RP1001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHF753ZMedicare PIN