MEDICARE: DR. CHARALAMPOS ZALAVRAS 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	207XX0801X	Orthopaedic Trauma Physician	A98297	CA

General Provider Information

NPI Number	:	1508922329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARALAMPOS ZALAVRAS M.D.

Provider Business Mailing Address
First Line	:	1200 N STATE ST
Second Line	:	GNH 3900, LAC-USC MEDICAL CENTER
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-1029
Country	:	US
Telephone Number	:	323-226-7346
Fax Number	:	323-226-4051

Provider Business Practice Location Address
First Line	:	1200 N STATE ST
Second Line	:	GNH 3900, LAC-USC MEDICAL CENTER
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-1029
Country	:	US
Telephone Number	:	323-226-7346
Fax Number	:	323-226-4051

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

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	07/08/2007

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