=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629096664
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMER ZARKA M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/17/2006
-----------------------------------------------------
Last Update Date | 11/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1220 HEMLOCK WAY STE 204
-----------------------------------------------------
City | SANTA ANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92707-3655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-266-1666
-----------------------------------------------------
Fax | 714-459-5950
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 62407
-----------------------------------------------------
City | IRVINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92602-6080
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-266-1666
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | A52935
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------