Healthcare Provider Details

I. General information

NPI: 1316292279
Provider Name (Legal Business Name): MARIA ZAGORZYCKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2012
Last Update Date: 07/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28022 CARNEGIE AVE # A
SANTA CLARITA CA
91350-3638
US

IV. Provider business mailing address

PO BOX 7068
NORTHRIDGE CA
91327-7068
US

V. Phone/Fax

Practice location:
  • Phone: 818-316-5701
  • Fax:
Mailing address:
  • Phone: 818-316-5701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG42996
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: