Provider Demographics
NPI:1356445373
Name:ZARETSKY, ADEL
Entity Type:Individual
Prefix:
First Name:ADEL
Middle Name:
Last Name:ZARETSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6225 WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5103
Mailing Address - Country:US
Mailing Address - Phone:323-954-1388
Mailing Address - Fax:323-954-1388
Practice Address - Street 1:6225 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5103
Practice Address - Country:US
Practice Address - Phone:323-954-1388
Practice Address - Fax:323-954-1388
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAUD1626237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU0016260Medicaid
CAAU0016261Medicaid