Provider Demographics
NPI:1801165477
Name:ZELDA S. DE LA CRUZ, M.D., INC.
Entity type:Organization
Organization Name:ZELDA S. DE LA CRUZ, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ZELDA
Authorized Official - Middle Name:SARMIENTO
Authorized Official - Last Name:DE LA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-375-8482
Mailing Address - Street 1:638 ALHAMBRA RD
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-2258
Mailing Address - Country:US
Mailing Address - Phone:650-375-8482
Mailing Address - Fax:650-375-8483
Practice Address - Street 1:1 BAYWOOD AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-1523
Practice Address - Country:US
Practice Address - Phone:650-375-8482
Practice Address - Fax:650-375-8483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-27
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty