Healthcare Provider Details

I. General information

NPI: 1710808803
Provider Name (Legal Business Name): MERICOPA MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2537 PACIFIC COAST HWY STE B
TORRANCE CA
90505-7064
US

IV. Provider business mailing address

2537 PACIFIC COAST HWY STE B
TORRANCE CA
90505-7064
US

V. Phone/Fax

Practice location:
  • Phone: 424-235-1562
  • Fax: 424-235-1561
Mailing address:
  • Phone: 424-235-1562
  • Fax: 424-235-1561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: MISA ZAKER
Title or Position: OWNER
Credential:
Phone: 310-995-6291