Provider Demographics
NPI:1447709746
Name:WILLIAM D. ZIGRANG, MD
Entity type:Organization
Organization Name:WILLIAM D. ZIGRANG, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCHETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-692-9751
Mailing Address - Street 1:1750 EL CAMINO REAL
Mailing Address - Street 2:202
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3228
Mailing Address - Country:US
Mailing Address - Phone:650-692-9751
Mailing Address - Fax:650-697-0729
Practice Address - Street 1:1750 EL CAMINO REAL
Practice Address - Street 2:202
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3228
Practice Address - Country:US
Practice Address - Phone:650-692-9751
Practice Address - Fax:650-697-0729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG26360207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G263600OtherMEDICARE PTAN
CA00G263600OtherMEDICARE PTAN