Provider Demographics
NPI:1821854910
Name:ZIZZO, STEVEN VINCENT (MD MPH CCFP DABOM OH)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:VINCENT
Last Name:ZIZZO
Suffix:
Gender:M
Credentials:MD MPH CCFP DABOM OH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 15TH ST UNIT 2149
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-8065
Mailing Address - Country:US
Mailing Address - Phone:904-907-9011
Mailing Address - Fax:
Practice Address - Street 1:122 15TH ST UNIT 2149
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-8065
Practice Address - Country:US
Practice Address - Phone:904-907-9011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC162411207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine