Provider Demographics
NPI:1275866519
Name:ZABLEN, MARSHALL (MD)
Entity Type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:
Last Name:ZABLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6265 SEPULVEDA BLVD SUITE 13
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-1130
Mailing Address - Country:US
Mailing Address - Phone:818-779-1900
Mailing Address - Fax:
Practice Address - Street 1:6265 SEPULVEDA BLVD SUITE 13
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1130
Practice Address - Country:US
Practice Address - Phone:818-779-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC33586207R00000X, 207RB0002X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA35319Medicare UPIN