Provider Demographics
NPI:1396775292
Name:VAN ZINO, KAREN A (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:A
Last Name:VAN ZINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4061 E CASTRO VALLEY BLVD
Mailing Address - Street 2:#403
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94552-4840
Mailing Address - Country:US
Mailing Address - Phone:925-484-4100
Mailing Address - Fax:510-581-5773
Practice Address - Street 1:4061 E CASTRO VALLEY BLVD
Practice Address - Street 2:#403
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94552-4840
Practice Address - Country:US
Practice Address - Phone:925-484-4100
Practice Address - Fax:510-581-5773
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG47813207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF08716Medicare UPIN
CA00G478130Medicare ID - Type Unspecified