Healthcare Provider Details

I. General information

NPI: 1366449985
Provider Name (Legal Business Name): VLADIMIR ZEETSER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2005
Last Update Date: 05/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 BALBOA BLVD STE 325
ENCINO CA
91316-5226
US

IV. Provider business mailing address

5400 BALBOA BLVD STE 325
ENCINO CA
91316-5226
US

V. Phone/Fax

Practice location:
  • Phone: 818-907-6100
  • Fax: 866-513-4995
Mailing address:
  • Phone: 818-907-6100
  • Fax: 866-513-4995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4504
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: