Provider Demographics
NPI:1740385624
Name:ADEL E. ZAKI, M.D. A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ADEL E. ZAKI, M.D. A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:ZAKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-660-2090
Mailing Address - Street 1:1233 N VERMONT AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1749
Mailing Address - Country:US
Mailing Address - Phone:323-660-2090
Mailing Address - Fax:323-953-9549
Practice Address - Street 1:1233 N VERMONT AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1749
Practice Address - Country:US
Practice Address - Phone:323-660-2090
Practice Address - Fax:323-953-9549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24061208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24061OtherMEDICAL LICENSE NUMBER
CA00A240610Medicaid
CA00A240610Medicaid
CAA23805Medicare UPIN
CACH893AMedicare PIN