Healthcare Provider Details

I. General information

NPI: 1750361093
Provider Name (Legal Business Name): MICHEL ZAKARI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 09/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S CENTRAL AVE SUITE 300
GLENDALE CA
91204-2530
US

IV. Provider business mailing address

1505 WILSON TER STE 155
GLENDALE CA
91206-4032
US

V. Phone/Fax

Practice location:
  • Phone: 818-242-0475
  • Fax: 818-662-0260
Mailing address:
  • Phone: 818-500-4055
  • Fax: 818-500-4065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA92507
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: