MEDICARE: KYLE ZANOCCO MD

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	208600000X	Surgery Physician	A134208	CA

General Provider Information

NPI Number	:	1750537775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE ZANOCCO MD

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD
Second Line	:	SUITE 400
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 UCLA MEDICAL PLZ STE 310
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-6999
Country	:	US
Telephone Number	:	310-026-7783
Fax Number	:	310-267-8632

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

Provider Enumeration Date	:	08/10/2008
Last Update Date	:	12/23/2019

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Directions to “ KYLE ZANOCCO MD” Practice Location

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