Healthcare Provider Details

I. General information

NPI: 1326171174
Provider Name (Legal Business Name): DR. ZEIN E. OBAGI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 N CANON DR SUITE 100
BEVERLY HILLS CA
90210-5323
US

IV. Provider business mailing address

270 N CANON DR SUITE 100
BEVERLY HILLS CA
90210-5323
US

V. Phone/Fax

Practice location:
  • Phone: 310-275-3030
  • Fax: 310-275-3873
Mailing address:
  • Phone: 310-275-3030
  • Fax: 310-275-3873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: