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General NPI Number Information
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NPI Number | 1548875347
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Entity Type | Individual
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Provider Name | REBECCA ZANZERKIA PA
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Gender | Female
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Dates
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Enumeration Date | 09/09/2020
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Last Update Date | 10/25/2023
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Provider Practice Location Address
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Address Line | 2125 ARIZONA AVE
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City | SANTA MONICA
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State | CA
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Zip | 90404-1337
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Country | US
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Telephone | 310-582-7450
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Fax | 310-582-7495
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Provider Business Mailing Address
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Address Line | 3 SHADOWBROOK DR
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City | NASHUA
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State | NH
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Zip | 03062-4543
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Country | US
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Telephone | 603-521-0716
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 025612
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 025612
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 025612
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 61428
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License Number State | CA
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