Active NPI
Alfred Victor Zamm, M.D.
- Dermatology Physician
- Malibu, CA
National Provider Identifier
1962595447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- G86321
- Practice address
- 29500 Heathercliff Rd SPC 46
Malibu, CA 90265-6046 - Phone
- (310) 457-4252
- Fax
- (310) 457-4253
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy Physician | 207KA0200X | 082532 | NY | |
| Dermatology Physician | 207N00000X | 082532 | NY | |
| Dermatology Physician | 207N00000X | G86321 | CA | Primary |
Addresses
Primary practice location
29500 Heathercliff Rd SPC 46
Malibu, CA 90265-6046
Mailing address
PO Box 4234
Malibu, CA 90264-4234
Phone (310) 457-4252
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00121155 | Medicaid | NY | |
| 127601 | Other | NY | EMPIRE B C/BS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G86321 | CA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482883200000",
"number": "1962595447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4234",
"city": "MALIBU",
"state": "CA",
"postal_code": "902644234",
"telephone_number": "310-457-4252",
"fax_number": "310-457-4253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29500 HEATHERCLIFF RD SPC 46",
"city": "MALIBU",
"state": "CA",
"postal_code": "902656046",
"telephone_number": "310-457-4252",
"fax_number": "310-457-4253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZAMM",
"first_name": "ALFRED",
"middle_name": "VICTOR",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2016-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "207KA0200X",
"taxonomy_group": "",
"desc": "Allergy & Immunology, Allergy",
"state": "NY",
"license": "082532",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "082532",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "G86321",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00121155",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE B C/BS",
"identifier": "127601",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Malibu, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.