Organization
ADVANCED LIFE CARE MEDICAL GROUP
Active
Other names
Michael A. Zona, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL A ZONA M.D. (OWNER)
(310) 261-0035
Entity
Organization
Contact information
Practice address
2255 S 88TH ST, LOUISVILLE, CO 80027-9716
(303) 673-9990
(949) 208-6981
Mailing address
PO BOX 819, NIWOT, CO 80544-0819
(310) 261-0035
(949) 208-6981
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G66875
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN3641
RR MEDICARE
CA
01
—
ZZZ48692Z
BLUE SHIELD
CA
Enumeration date
07/10/2006
Last updated
01/26/2011
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