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General NPI Number Information
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NPI Number | 1407838303
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Entity Type | Individual
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Provider Name | NICHOLAS VALERIOS ZEKOS MD
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Gender | Male
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 12/30/2010
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Provider Practice Location Address
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Address Line | 7117 BROCKTON AVE
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City | RIVERSIDE
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State | CA
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Zip | 92506-2615
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Country | US
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Telephone | 951-782-3650
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Fax | 951-784-3260
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Provider Business Mailing Address
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Address Line | 3660 ARLINGTON AVE
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City | RIVERSIDE
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State | CA
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Zip | 92506-3912
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Country | US
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Telephone | 951-782-5110
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Fax | 951-274-0403
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A38241
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | A38241
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License Number State | CA
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