| 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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