MEDICARE: DR. JOHN TZANOS PHD

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
1	103T00000X	Psychologist	0005979	CO

General Provider Information

NPI Number	:	1366141103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN TZANOS PHD

Provider Business Mailing Address
First Line	:	6230 WILSHIRE BLVD STE A
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5126
Country	:	US
Telephone Number	:	720-307-7378
Fax Number	:

Provider Business Practice Location Address
First Line	:	6230 WILSHIRE BLVD STE A
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5126
Country	:	US
Telephone Number	:	720-307-7378
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2023
Last Update Date	:	12/27/2025

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Directions to “ DR. JOHN TZANOS PHD” Practice Location

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