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General NPI Number Information
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NPI Number | 1164779781
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Entity Type | Organization
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Legal Business Name | MAURICE T. ZAGHA, M.D., INC
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Dates
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Enumeration Date | 08/14/2012
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | 16133 VENTURA BLVD STE 300
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City | ENCINO
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State | CA
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Zip | 91436-2428
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Country | US
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Telephone | 818-907-6525
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Fax | 818-907-7418
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Provider Business Mailing Address
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Address Line | 16133 VENTURA BLVD STE 300
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City | ENCINO
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State | CA
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Zip | 91436-2428
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Country | US
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Telephone | 818-907-6525
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Fax | 818-907-7418
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Authorized Official
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Title or Position | OWNER
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Name | MAURICE T. ZAGHA
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Credential | M.D.
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Telephone | 818-907-6525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A34602
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License Number State | CA
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