| Zenketamine | |
| 
					6538 Lonetree Blvd. Ste. 100 Rocklin CA 95765-5899  | |
| (916) 532-3418 | |
| (916) 532-9653 | 
| Full Name | Zenketamine | 
|---|---|
| Speciality | Family Medicine | 
| Location | 6538 Lonetree Blvd. Ste. 100, Rocklin, California | 
| Authorized Official Name and Position | Erwin Victor Salvador Boco (PRESIDENT & CEO) | 
| Authorized Official Contact | 9168446617 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Zenketamine 6538 Lonetree Blvd. Ste. 100 Rocklin CA 95765-5899 Ph: (916) 532-3418  | Zenketamine 6538 Lonetree Blvd. Ste. 100 Rocklin CA 95765-5899 Ph: (916) 532-3418  | 
| NPI Number | 1659151389 | 
|---|---|
| Provider Enumeration Date | 10/02/2023 | 
| Last Update Date | 10/02/2023 | 
| Medicare PECOS PAC ID | 9436507803 | 
|---|---|
| Medicare Enrollment ID | O20240124004851 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1659151389 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary | 
| Provider Name | Erwin Victor S Boco | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1851657936 PECOS PAC ID: 9436314697 Enrollment ID: I20120713000348  | 
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