Healthcare Provider Details

I. General information

NPI: 1891997706
Provider Name (Legal Business Name): MR. JOSEPH GABRIEL ZIEBELL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST BOX 488 DEPT OF PSYCHIATRY HARBOR UCLA MEDICAL CENTER
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

1320 PRIMROSE ST UNIT 4
UPLAND CA
91786-6258
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-3198
  • Fax: 310-222-3521
Mailing address:
  • Phone: 909-472-6243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: