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General NPI Number Information
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NPI Number | 1184867624
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Entity Type | Organization
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Legal Business Name | H G ZIAEE MD CORP
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 04/17/2009
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Provider Practice Location Address
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Address Line | 12212 W WASHINGTON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90066-5508
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Country | US
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Telephone | 310-391-5241
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Fax | 310-397-4324
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Provider Business Mailing Address
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Address Line | 5258 NEWCASTLE AVE # 20
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City | ENCINO
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State | CA
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Zip | 91316-3078
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Country | US
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Telephone | 818-342-5771
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Fax | 818-342-5771
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Authorized Official
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Title or Position | PRESIDENT
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Name | HOSSEINGHOLI ZIAEE
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Credential | M.D.
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Telephone | 818-342-5771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A89604
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License Number State | CA
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