Provider Demographics
NPI:1871839233
Name:ZEDNER, ISAAC NISSAN (PA)
Entity Type:Individual
Prefix:MR
First Name:ISAAC
Middle Name:NISSAN
Last Name:ZEDNER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9100 WILSHIRE BLVD STE 363W
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3464
Mailing Address - Country:US
Mailing Address - Phone:310-409-3537
Mailing Address - Fax:
Practice Address - Street 1:9100 WILSHIRE BLVD STE 363W
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3464
Practice Address - Country:US
Practice Address - Phone:310-409-3537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-12
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22581363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant