Provider Demographics
NPI:1952316713
Name:NORMAN R. ZINNER, M.D., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:NORMAN R. ZINNER, M.D., A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:AVRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-373-9452
Mailing Address - Street 1:23441 MADISON ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4725
Mailing Address - Country:US
Mailing Address - Phone:310-373-9452
Mailing Address - Fax:310-373-7451
Practice Address - Street 1:23441 MADISON ST
Practice Address - Street 2:SUITE 140
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4725
Practice Address - Country:US
Practice Address - Phone:310-373-9452
Practice Address - Fax:310-373-7451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG18165208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G181650Medicaid
A40286Medicare UPIN
WG18165Medicare ID - Type Unspecified