Healthcare Provider Details

I. General information

NPI: 1679689822
Provider Name (Legal Business Name): JAMES P ZALEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 SANTA MONICA BLVD SUITE 860
SANTA MONICA CA
90404-2102
US

IV. Provider business mailing address

6029 BRISTOL PKWY 100
CULVER CITY CA
90230-6643
US

V. Phone/Fax

Practice location:
  • Phone: 310-828-3209
  • Fax: 310-828-5165
Mailing address:
  • Phone: 310-417-5900
  • Fax: 310-410-1001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberG65652
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: