Provider Demographics
NPI:1518972967
Name:VLADIMIR ZEETSER, DPM, INC.
Entity Type:Organization
Organization Name:VLADIMIR ZEETSER, DPM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEETSER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:818-907-6100
Mailing Address - Street 1:5400 BALBOA BLVD STE 325
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-5226
Mailing Address - Country:US
Mailing Address - Phone:818-907-6100
Mailing Address - Fax:866-513-4995
Practice Address - Street 1:5400 BALBOA BLVD STE 325
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-5226
Practice Address - Country:US
Practice Address - Phone:818-907-6100
Practice Address - Fax:866-513-4995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4504213ES0103X
CA5418910001332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E45041Medicaid
CA5418910001Medicare NSC
CAU99040Medicare UPIN
CAWE4504AMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CAW18139Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER