Individual provider Active NPI

Barry Todd Zimmer, L.AC.

  • Acupuncturist
  • San Diego, CA
National Provider Identifier
1720102601
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC 9358 Issued in CA
Practice address
11777 Bernardo Plaza CT
Suite 107
San Diego, CA 92128-2405
Phone
(858) 487-8246
Fax
(858) 487-8246
NPI assigned
Mar 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC 9358 CA Primary

Addresses

Primary practice location

11777 Bernardo Plaza CT
Suite 107
San Diego, CA 92128-2405

Mailing address

15752 Via Calanova
San Diego, CA 92128-4429
Phone (858) 335-4359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC 9358CAMDAcupuncturist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1720102601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15752 VIA CALANOVA",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284429",
            "telephone_number": "858-335-4359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11777 BERNARDO PLAZA CT",
            "address_2": "SUITE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282405",
            "telephone_number": "858-487-8246",
            "fax_number": "858-487-8246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMER",
        "first_name": "BARRY",
        "middle_name": "TODD",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 9358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.