Provider Demographics
NPI:1902995384
Name:ZARANKOW, BEATA (MD)
Entity Type:Individual
Prefix:
First Name:BEATA
Middle Name:
Last Name:ZARANKOW
Suffix:
Gender:F
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:DEPARTMENT OF VETERAN AFFAIRS HEALTH CARE
Mailing Address - Street 2:3350 LA JOLLA VILLAGE DRIVE
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92161-0001
Mailing Address - Country:US
Mailing Address - Phone:619-476-6042
Mailing Address - Fax:619-476-6077
Practice Address - Street 1:DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE
Practice Address - Street 2:3350 LA JOLLA VILLAGE DRIVE
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-0001
Practice Address - Country:US
Practice Address - Phone:619-476-6042
Practice Address - Fax:619-476-6077
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC536562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME290940099Medicaid
ME290940099Medicaid