Provider Demographics
NPI:1871664094
Name:MIRALI ZARRABI MD A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:MIRALI ZARRABI MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIRALI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARRABI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-642-7774
Mailing Address - Street 1:9601 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 1170
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5213
Mailing Address - Country:US
Mailing Address - Phone:310-642-7774
Mailing Address - Fax:310-868-0444
Practice Address - Street 1:5901 W OLYMPIC BLVD
Practice Address - Street 2:SUITE 508
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4667
Practice Address - Country:US
Practice Address - Phone:310-642-7774
Practice Address - Fax:310-868-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64722207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A647220Medicaid
CAA64722OtherMEDICAL BOARD OF CALIFORNIA
CAA64722OtherMEDICAL BOARD OF CALIFORNIA
CAA64722AMedicare ID - Type Unspecified