Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 9177 | CA |
N | 103TC0700X | Clinical Psychologist | 9177 | CA |
NPI | 1013042902 |
---|---|
Provider Name | Dr. Peter J Zucker |
First Address | Manhattan Beach, CA 90266-2231 |
Second Address | Long Beach, CA 90810-1876 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 08/07/2007 |