Provider Demographics
NPI:1407485493
Name:GUPTA ZANDIFAR OPERATING ACCOUNT
Entity Type:Organization
Organization Name:GUPTA ZANDIFAR OPERATING ACCOUNT
Other - Org Name:BEVERLY HILLS ENT AND FACIAL PLASTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOOTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZANDIFAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-736-4272
Mailing Address - Street 1:324 S BEVERLY DR # 482
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4801
Mailing Address - Country:US
Mailing Address - Phone:310-736-4272
Mailing Address - Fax:
Practice Address - Street 1:8920 WILSHIRE BLVD STE 604
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2006
Practice Address - Country:US
Practice Address - Phone:310-736-4272
Practice Address - Fax:310-496-7235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Multi-Specialty