Provider Demographics
NPI:1346264793
Name:ZISSER, MILLARD HUGH (MD)
Entity Type:Individual
Prefix:DR
First Name:MILLARD
Middle Name:HUGH
Last Name:ZISSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8631 WEST THIRD STREET
Mailing Address - Street 2:545-E
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5901
Mailing Address - Country:US
Mailing Address - Phone:310-659-2770
Mailing Address - Fax:310-659-1846
Practice Address - Street 1:8631 W 3RD ST
Practice Address - Street 2:545-E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5901
Practice Address - Country:US
Practice Address - Phone:310-659-2770
Practice Address - Fax:310-659-1846
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA30111207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology