Provider Demographics
NPI:1164889697
Name:ZADBEH, NETANEL (BC-HIS)
Entity Type:Individual
Prefix:
First Name:NETANEL
Middle Name:
Last Name:ZADBEH
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5067 ZELZAH AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3628
Mailing Address - Country:US
Mailing Address - Phone:917-523-8198
Mailing Address - Fax:
Practice Address - Street 1:19013 VENTURA BLVD STE G
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3213
Practice Address - Country:US
Practice Address - Phone:818-666-0115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA 8053237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist