Healthcare Provider Details

I. General information

NPI: 1427039437
Provider Name (Legal Business Name): ERIK N ZEEGEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 01/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5525 ETIWANDA STE 324
TARZANA CA
91436-3647
US

IV. Provider business mailing address

5525 ETIWANDA AVE SUITE 324
TARZANA CA
91356-3647
US

V. Phone/Fax

Practice location:
  • Phone: 818-708-9090
  • Fax: 818-708-3901
Mailing address:
  • Phone: 818-708-9090
  • Fax: 818-708-3901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA64195
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberA64195
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: