Healthcare Provider Details

I. General information

NPI: 1952703803
Provider Name (Legal Business Name): ALEN ZEHNALY, M.D., A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2014
Last Update Date: 02/24/2022
Certification Date: 02/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E CHEVY CHASE DR
GLENDALE CA
91205-3017
US

IV. Provider business mailing address

PO BOX 7001
TARZANA CA
91357-7001
US

V. Phone/Fax

Practice location:
  • Phone: 818-265-2275
  • Fax:
Mailing address:
  • Phone: 818-888-7815
  • Fax: 818-715-1722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA106609
License Number StateCA

VIII. Authorized Official

Name: ALEN ZEHNALY
Title or Position: PRESIDENT/ SOLE OWNER
Credential: M.D.
Phone: 626-755-5140