Provider Demographics
NPI:1851954721
Name:ZWEIFEL, JOSEPH HAROLD
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:HAROLD
Last Name:ZWEIFEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4694 SHIELDS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-2928
Mailing Address - Country:US
Mailing Address - Phone:330-421-1411
Mailing Address - Fax:
Practice Address - Street 1:4694 SHIELDS ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92124-2928
Practice Address - Country:US
Practice Address - Phone:330-421-1411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ140-488-83-367-0OtherDRIVERS