Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 297134 | CA |
N | 2251N0400X | Physical Therapist - Neurology | 297134 | CA |
N | 2251S0007X | Physical Therapist - Sports | 297134 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | 297134 | CA |
N | 225200000X | Physical Therapy Assistant | 10010 | CA |
NPI | 1679965875 |
---|---|
Provider Name | Zachary Q Zimmerman |
First Address | San Diego, CA 92109-5800 |
Second Address | San Diego, CA 92123-4223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2015 |
Last Update Date | 24/06/2021 |