Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | C145502 | CA |
Y | 111NI0900X | Internist | C145502 | CA |
N | 207RA0401X | Internist - Addiction Medicine | 6922 | AK |
NPI | 1649212770 |
---|---|
Provider Name | Dr. John D Zipperer JR. |
First Address | Adelanto, CA 92301-1709 |
Second Address | Adelanto, CA 92301-1709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 09/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H52875 | (02) |