Provider Demographics
NPI:1740358399
Name:ZAPPER, CHRIS MICHAEL (OD)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:MICHAEL
Last Name:ZAPPER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 S. DIAMOND BAR BLVD.
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-4122
Mailing Address - Country:US
Mailing Address - Phone:909-861-4999
Mailing Address - Fax:909-396-1715
Practice Address - Street 1:1255 S. DIAMOND BAR BLVD.
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-4122
Practice Address - Country:US
Practice Address - Phone:909-861-4999
Practice Address - Fax:909-396-1715
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT6147T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU75978Medicare UPIN