Healthcare Provider Details

I. General information

NPI: 1609418482
Provider Name (Legal Business Name): ZAMPELL MICROSURGICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2019
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 N BEDFORD DR STE 206
BEVERLY HILLS CA
90210-4317
US

IV. Provider business mailing address

416 N BEDFORD DR STE 206
BEVERLY HILLS CA
90210-4317
US

V. Phone/Fax

Practice location:
  • Phone: 310-620-8750
  • Fax: 310-620-8751
Mailing address:
  • Phone: 310-620-8750
  • Fax: 310-620-8751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMIE ZAMPELL
Title or Position: OWNER
Credential: MD
Phone: 917-599-8702