Provider Demographics
NPI:1750361093
Name:ZAKARI, MICHEL (MD)
Entity type:Individual
Prefix:
First Name:MICHEL
Middle Name:
Last Name:ZAKARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1505 WILSON TER
Mailing Address - Street 2:STE 155
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4032
Mailing Address - Country:US
Mailing Address - Phone:818-500-4055
Mailing Address - Fax:818-500-4065
Practice Address - Street 1:1500 S CENTRAL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2530
Practice Address - Country:US
Practice Address - Phone:818-242-0475
Practice Address - Fax:818-662-0260
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA92507207RN0300X, 208M00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI48042Medicare UPIN