Healthcare Provider Details

I. General information

NPI: 1225521305
Provider Name (Legal Business Name): RACHEL TROY ZIPURSKY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2018
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 W SUNSET BLVD # MS 61
LOS ANGELES CA
90027-6062
US

IV. Provider business mailing address

4650 W SUNSET BLVD # 61
LOS ANGELES CA
90027-6062
US

V. Phone/Fax

Practice location:
  • Phone: 310-614-0805
  • Fax:
Mailing address:
  • Phone: 310-614-0805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number177394
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT215515
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: