Provider Demographics
NPI:1912005349
Name:DELZEIT, MONICA BARBARA (MD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:BARBARA
Last Name:DELZEIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 GREAT OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119
Mailing Address - Country:US
Mailing Address - Phone:408-363-3000
Mailing Address - Fax:408-363-3088
Practice Address - Street 1:80 GREAT OAKS BLVD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119
Practice Address - Country:US
Practice Address - Phone:408-363-3000
Practice Address - Fax:408-363-3088
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG063958207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E61307Medicare UPIN