Provider Demographics
NPI:1013063502
Name:RICHARD F ZIPF MD MEDICAL CORP
Entity Type:Organization
Organization Name:RICHARD F ZIPF MD MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:FERDINAND
Authorized Official - Last Name:ZIPF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-487-9198
Mailing Address - Street 1:4925 J STREET
Mailing Address - Street 2:
Mailing Address - City:SACARAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3828
Mailing Address - Country:US
Mailing Address - Phone:916-487-9198
Mailing Address - Fax:916-481-1615
Practice Address - Street 1:4925 J STREET
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3828
Practice Address - Country:US
Practice Address - Phone:916-487-9198
Practice Address - Fax:916-481-1615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG11397207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G113970Medicaid
180025520OtherRAILROAD MEDICARE
958190000OtherTRICARE
CACGP128485OtherCCS - STATE
ZZZ06498ZOtherMEDICARE PTAN
CA00G113970OtherBILLING ID#
1013063502OtherNPI
195715900OtherDEPT. OF LABOR
CACGP128485OtherCCS - STATE
180025520OtherRAILROAD MEDICARE
195715900OtherDEPT. OF LABOR