Healthcare Provider Details

I. General information

NPI: 1629210729
Provider Name (Legal Business Name): SHEREEN T ZURNAMER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2009
Last Update Date: 04/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8631 W 3RD ST SUITE 800E
LOS ANGELES CA
90048-5901
US

IV. Provider business mailing address

8631 W 3RD ST SUITE 800E
LOS ANGELES CA
90048-5901
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-7900
  • Fax: 310-423-0810
Mailing address:
  • Phone: 310-423-7900
  • Fax: 310-423-0810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA16375
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: