Provider Demographics
NPI:1437430378
Name:ANDREW L ZAK M D A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ANDREW L ZAK M D A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:A PROFESSIONAL CORPORATION
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZAK
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:702-487-6510
Mailing Address - Street 1:9720 VERLAINE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-8695
Mailing Address - Country:US
Mailing Address - Phone:702-487-6510
Mailing Address - Fax:702-405-7960
Practice Address - Street 1:9720 VERLAINE CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-8695
Practice Address - Country:US
Practice Address - Phone:702-487-6510
Practice Address - Fax:702-405-7960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-06
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty