Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | G39110 | CA |
Y | 2086S0129X | Vascular Surgeon | G39110 | CA |
NPI | 1093729121 |
---|---|
Provider Name | Dr. James Jerome Zimmerman |
First Address | Los Altos, CA 94022-1408 |
Second Address | Redwood City, CA 94062-2851 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 28/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G391100 | (05) | CA |
A47707 | (02) | CA |
CP2153 | MEDICARE RAILROAD (01) | CA |
GR0052800 | (05) | CA |