Provider Demographics
NPI:1255323408
Name:M ZARRABI MEDICAL CORPORATION
Entity Type:Organization
Organization Name:M ZARRABI MEDICAL CORPORATION
Other - Org Name:AMERICAN MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANOOCHEHR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARRABI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-339-8577
Mailing Address - Street 1:4827 GAGE AVE
Mailing Address - Street 2:
Mailing Address - City:BELL
Mailing Address - State:CA
Mailing Address - Zip Code:90201-1424
Mailing Address - Country:US
Mailing Address - Phone:323-567-7722
Mailing Address - Fax:323-537-4749
Practice Address - Street 1:3175 TWEEDY BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-5739
Practice Address - Country:US
Practice Address - Phone:323-567-7722
Practice Address - Fax:323-537-4749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45355174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0059020Medicaid
CAGR0059020Medicaid