Provider Demographics
NPI:1184722332
Name:ZITMAN, SHELDON (MD)
Entity type:Individual
Prefix:
First Name:SHELDON
Middle Name:
Last Name:ZITMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20555 PROSPECT ROAD
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014
Mailing Address - Country:US
Mailing Address - Phone:408-996-9339
Mailing Address - Fax:408-996-3550
Practice Address - Street 1:20555 PROSPECT ROAD
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014
Practice Address - Country:US
Practice Address - Phone:408-996-9339
Practice Address - Fax:408-996-3550
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG37930207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA47290Medicare UPIN
CA00G379300Medicare PIN