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NPI Code Detail

MEDICARE: MILA ZATULOVSKY M.D.

MEDICARE:   MILA  ZATULOVSKY  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianA54500CA

General Provider Information

NPI Number : 1104984715
Entity Type Code : Individual
Provider Name (Legal Business Name) : MILA ZATULOVSKY M.D.
Provider Business Mailing Address
First Line : 1121 21ST ST UNIT 1
Second Line :
City : SANTA MONICA
State : CA
Zip : 90403-5623
Country : US
Telephone Number : 310-315-1536
Fax Number :
Provider Business Practice Location Address
First Line : 1009 N AVALON BLVD
Second Line :
City : WILMINGTON
State : CA
Zip : 90744-4505
Country : US
Telephone Number : 310-549-5760
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2006
Last Update Date : 07/08/2007

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Directions to “ MILA ZATULOVSKY M.D.” Practice Location

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