Provider Demographics
NPI:1942208848
Name:ZETTERLUND, PATRIK CARL (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRIK
Middle Name:CARL
Last Name:ZETTERLUND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 SAN JOSE ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3901
Mailing Address - Country:US
Mailing Address - Phone:831-758-2100
Mailing Address - Fax:831-758-1565
Practice Address - Street 1:230 SAN JOSE ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3901
Practice Address - Country:US
Practice Address - Phone:831-758-2100
Practice Address - Fax:831-758-1565
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45195207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA110092029OtherRAILROAD MEDICARE CCC
CA00A451950Medicaid
CA930055586OtherRAILROAD MEDICARE SVMH READING
CAA00045195OtherBLUE CROSS
CA00A451950Medicaid
CA110092029OtherRAILROAD MEDICARE CCC
CAE21113Medicare UPIN