Healthcare Provider Details

I. General information

NPI: 1699014175
Provider Name (Legal Business Name): ZAK MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2013
Last Update Date: 02/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73710 ALESSANDRO DR SUITE A1
PALM DESERT CA
92260-3638
US

IV. Provider business mailing address

73710 ALESSANDRO DR SUITE A1
PALM DESERT CA
92260-3638
US

V. Phone/Fax

Practice location:
  • Phone: 760-834-0364
  • Fax:
Mailing address:
  • Phone: 760-834-0364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberA61113
License Number StateCA

VIII. Authorized Official

Name: DR. MOHAMMED ZAKHIREH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 760-837-0364