Provider Demographics
NPI:1407171465
Name:M. ZARAY-MIZRAHI, M.D., INC
Entity Type:Organization
Organization Name:M. ZARAY-MIZRAHI, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MORDEHAI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARAY-MIZRAHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-981-0428
Mailing Address - Street 1:5170 SEPULVEDA BLVD
Mailing Address - Street 2:270
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1171
Mailing Address - Country:US
Mailing Address - Phone:818-981-0428
Mailing Address - Fax:818-981-0432
Practice Address - Street 1:5170 SEPULVEDA BLVD
Practice Address - Street 2:270
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1171
Practice Address - Country:US
Practice Address - Phone:818-981-0428
Practice Address - Fax:818-981-0432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-02
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35870208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty