Healthcare Provider Details

I. General information

NPI: 1346942133
Provider Name (Legal Business Name): ZAGHI MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2023
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5665 WILSHIRE BLVD # 1609
LOS ANGELES CA
90036-3710
US

IV. Provider business mailing address

5665 WILSHIRE BLVD # 1609
LOS ANGELES CA
90036-3710
US

V. Phone/Fax

Practice location:
  • Phone: 424-600-8360
  • Fax:
Mailing address:
  • Phone: 424-600-8360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JUSTIN ZAGHI
Title or Position: PRESIDENT
Credential: MD
Phone: 424-600-8360