Healthcare Provider Details

I. General information

NPI: 1053526780
Provider Name (Legal Business Name): GUILDA ZOKAEEM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 N CRESCENT DR #225
BEVERLY HILLS CA
90210-4860
US

IV. Provider business mailing address

1799 WESTRIDGE RD
LOS ANGELES CA
90049-2515
US

V. Phone/Fax

Practice location:
  • Phone: 310-858-2928
  • Fax:
Mailing address:
  • Phone: 310-476-4504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA52755
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: