Provider Demographics
NPI:1679539951
Name:CSUKA, ZOLTAN (MD)
Entity type:Individual
Prefix:
First Name:ZOLTAN
Middle Name:
Last Name:CSUKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 WHITE FLOWER
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-0121
Mailing Address - Country:US
Mailing Address - Phone:949-648-6763
Mailing Address - Fax:
Practice Address - Street 1:369 SAN MIGUEL DR STE 200
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7850
Practice Address - Country:US
Practice Address - Phone:949-648-6763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC130981207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00957604OtherRR MEDICARE
IN200278570Medicaid
IN000000572794OtherANTHEM
IN000000702844OtherANTHEM
INP00957604OtherRR MEDICARE
IN200278570Medicaid
INM400040534Medicare PIN