Provider Demographics
NPI:1962502401
Name:ZEMELLA, PAUL MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MICHAEL
Last Name:ZEMELLA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3022 STATE ST STE B
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3353
Mailing Address - Country:US
Mailing Address - Phone:805-687-6629
Mailing Address - Fax:805-687-0675
Practice Address - Street 1:3022 STATE ST STE B
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3353
Practice Address - Country:US
Practice Address - Phone:805-687-6629
Practice Address - Fax:805-687-0675
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77-0582901111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME5293712Medicaid
CAWDC4709Medicare ID - Type UnspecifiedMEDICARE GROUP #
CAWDC10441AMedicare PIN