Healthcare Provider Details

I. General information

NPI: 1073673851
Provider Name (Legal Business Name): MICHAEL ZARRABI MD INC -A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date: 04/19/2010
Reactivation Date: 08/12/2011

III. Provider practice location address

150 S RODEO DR STE 200
BEVERLY HILLS CA
90212-2440
US

IV. Provider business mailing address

150 S RODEO DR STE 200
BEVERLY HILLS CA
90212-2440
US

V. Phone/Fax

Practice location:
  • Phone: 310-584-9990
  • Fax: 310-929-9762
Mailing address:
  • Phone: 310-584-9990
  • Fax: 310-929-9762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberA95159
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA95159
License Number StateCA

VIII. Authorized Official

Name: DR. MICHAEL ZARRABI
Title or Position: PRESIDENT OF CORPORATION
Credential: M.D.
Phone: 310-584-9990