MEDICARE: ZAHN & ASSOCIATES A MEDICAL CORPORATION

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	174400000X	Specialist	G69510	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	05D0930021	OTHER	CA	CLIA WAIVER

General Provider Information

NPI Number	:	1912059478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZAHN & ASSOCIATES A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	1026 E LAS TUNAS DRIVE
Second Line	:
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776-1633
Country	:	US
Telephone Number	:	626-287-7222
Fax Number	:	626-287-1991

Provider Business Practice Location Address
First Line	:	1026 E LAS TUNAS DRIVE
Second Line	:
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776-1633
Country	:	US
Telephone Number	:	626-287-7222
Fax Number	:	626-287-1991

Authorized Official
Title or Position	:	CEO
Name	:	CHESTER D ZAHN
Credential	:	MD
Telephone Number	:	626-287-7222

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	03/30/2020

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