Provider Demographics
NPI:1447330634
Name:ZEITER, JOHN HENRY (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:HENRY
Last Name:ZEITER
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 1:255 E WEBER AVE
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95202-2706
Mailing Address - Country:US
Mailing Address - Phone:209-466-5566
Mailing Address - Fax:209-466-0535
Practice Address - Street 1:255 E WEBER AVE
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95202-2706
Practice Address - Country:US
Practice Address - Phone:209-466-5566
Practice Address - Fax:209-466-0535
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46664207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A466640Medicaid
CAF09487Medicare UPIN
CA00A466645Medicare PIN
CA00A466640Medicare PIN
CA00A466642Medicare PIN
CA00A466644Medicare PIN
CADA640YMedicare PIN
CA00A466641Medicare PIN
CA00A466643Medicare PIN