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General NPI Number Information
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NPI Number | 1477888154
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Entity Type | Individual
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Provider Name | DIANA ZAGALSKAYA M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/13/2009
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Last Update Date | 10/13/2009
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Provider Practice Location Address
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Address Line | 14111 VAN NESS AVE
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City | GARDENA
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State | CA
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Zip | 90249-2950
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Country | US
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Telephone | 310-329-2121
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Fax |
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Provider Business Mailing Address
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Address Line | 1037 N VISTA ST APT 202
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90046-6632
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Country | US
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Telephone | 323-449-3019
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Fax | 323-512-7863
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A106875
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License Number State | CA
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