Provider Demographics
NPI:1780850172
Name:ZARRABI, MANOOCHEHR (MD)
Entity Type:Individual
Prefix:DR
First Name:MANOOCHEHR
Middle Name:
Last Name:ZARRABI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4827 GAGE AVE
Mailing Address - Street 2:
Mailing Address - City:BELL
Mailing Address - State:CA
Mailing Address - Zip Code:90201-1424
Mailing Address - Country:US
Mailing Address - Phone:323-773-3000
Mailing Address - Fax:323-773-8595
Practice Address - Street 1:4827 GAGE AVE
Practice Address - Street 2:
Practice Address - City:BELL
Practice Address - State:CA
Practice Address - Zip Code:90201-1424
Practice Address - Country:US
Practice Address - Phone:323-773-3000
Practice Address - Fax:323-773-8595
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45355207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE56503Medicare UPIN