Provider Demographics
NPI:1134761091
Name:ZAHRA ESMAIL D O PROFESSIONAL CORP
Entity type:Organization
Organization Name:ZAHRA ESMAIL D O PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZAHRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESMAIL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:909-717-7312
Mailing Address - Street 1:PO BOX 17412
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90209-3412
Mailing Address - Country:US
Mailing Address - Phone:310-273-7365
Mailing Address - Fax:310-273-7366
Practice Address - Street 1:4101 TORRANCE BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4607
Practice Address - Country:US
Practice Address - Phone:310-303-3854
Practice Address - Fax:310-303-6861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-11
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty