Provider Demographics
NPI:1023690591
Name:STEPHEN ZILBER, LAC, PC
Entity type:Organization
Organization Name:STEPHEN ZILBER, LAC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZILBER
Authorized Official - Suffix:
Authorized Official - Credentials:DACM, LAC
Authorized Official - Phone:855-488-1800
Mailing Address - Street 1:1020 GRAVENSTEIN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-4570
Mailing Address - Country:US
Mailing Address - Phone:855-488-1800
Mailing Address - Fax:707-639-1350
Practice Address - Street 1:1020 GRAVENSTEIN AVE STE 100
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-4570
Practice Address - Country:US
Practice Address - Phone:855-488-1800
Practice Address - Fax:707-639-1350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-24
Last Update Date:2021-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty