Healthcare Provider Details

I. General information

NPI: 1619435427
Provider Name (Legal Business Name): ZEB MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2019
Last Update Date: 03/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12134 VICTORY BLVD STE C
NORTH HOLLYWOOD CA
91606-3205
US

IV. Provider business mailing address

12134 VICTORY BLVD STE C
NORTH HOLLYWOOD CA
91606-3205
US

V. Phone/Fax

Practice location:
  • Phone: 818-762-8702
  • Fax: 818-761-2583
Mailing address:
  • Phone: 818-762-8702
  • Fax: 818-761-2583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ARCHIE MAYS
Title or Position: ADMINISTRATOR
Credential:
Phone: 818-762-8702