Organization
MARIN PACIFIC MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JEFFREY ZIZMOR MD (PHYSICIAN)
(341) 222-3800
Entity
Organization
Contact information
Practice address
1849 SAWTELLE BLVD STE 610, LOS ANGELES, CA 90025-7013
(341) 217-8411
Mailing address
1935A ADDISON ST STE 200, BERKELEY, CA 94704-1101
(341) 217-8411
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
06/07/2024
Last updated
07/24/2025
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