MEDICARE: DR. RONDA ADHAM ZULICH 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
1	208000000X	Pediatrics Physician	16810	NV
2	208000000X	Pediatrics Physician	9066314-1205	UT
3	208000000X	Pediatrics Physician	9066314-8905	UT
4	208000000X	Pediatrics Physician	A97521	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376688481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONDA ADHAM ZULICH M.D.

Provider Business Mailing Address
First Line	:	2050 MARINER DR STE 150
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-6656
Country	:	US
Telephone Number	:	702-850-5437
Fax Number	:	702-850-7337

Provider Business Practice Location Address
First Line	:	2050 MARINER DR STE 150
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-6656
Country	:	US
Telephone Number	:	702-850-5437
Fax Number	:	702-850-7337

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

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	05/03/2022

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Directions to “ DR. RONDA ADHAM ZULICH M.D.” Practice Location

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