Provider Demographics
NPI:1912089525
Name:MARK ZEME
Entity Type:Organization
Organization Name:MARK ZEME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEME
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:510-889-6673
Mailing Address - Street 1:20083 LAKE CHABOT RD
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5303
Mailing Address - Country:US
Mailing Address - Phone:510-889-6673
Mailing Address - Fax:510-889-0913
Practice Address - Street 1:20083 LAKE CHABOT RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5303
Practice Address - Country:US
Practice Address - Phone:510-889-6673
Practice Address - Fax:510-889-0913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG66448207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty