Healthcare Provider Details

I. General information

NPI: 1780115626
Provider Name (Legal Business Name): ZACHARY JONATHAN COLLIER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 MEDICAL CENTER DR STE 500
WEST HILLS CA
91307-4101
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 818-676-4726
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA160977
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: