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NPI Code Detail

MEDICARE: JILL MAZZA M.D.

MEDICARE: JILL MAZZA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207YX0007XPlastic Surgery within the Head & Neck (Otolaryngology) PhysicianA113348CA
2207Y00000XOtolaryngology PhysicianA113348CA

General Provider Information

NPI Number : 1700049731
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL MAZZA M.D.
Provider Business Mailing Address
First Line : 191 S BUENA VISTA ST STE 320
Second Line :
City : BURBANK
State : CA
Zip : 91505-4556
Country : US
Telephone Number : 818-559-9727
Fax Number : 818-559-5514
Provider Business Practice Location Address
First Line : 501 S BUENA VISTA ST
Second Line :
City : BURBANK
State : CA
Zip : 91505-4809
Country : US
Telephone Number : 818-847-6049
Fax Number : 818-847-4842
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2008
Last Update Date : 09/22/2025

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