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General NPI Number Information
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NPI Number | 1184431876
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Entity Type | Organization
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Legal Business Name | LIANE ZWETZICH MD A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 245 TRANQUILLO RD
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-3143
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Country | US
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Telephone | 917-373-1338
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Fax |
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Provider Business Mailing Address
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Address Line | 950 N KINGS RD UNIT 310
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069-4336
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Country | US
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Telephone | 917-373-1338
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LIANE ZWETZICH
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Credential | MD
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Telephone | 917-373-1338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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