Provider Demographics
NPI:1912059478
Name:ZAHN & ASSOCIATES A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ZAHN & ASSOCIATES A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:D
Authorized Official - Last Name:ZAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-287-7222
Mailing Address - Street 1:1026 E LAS TUNAS DRIVE
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1633
Mailing Address - Country:US
Mailing Address - Phone:626-287-7222
Mailing Address - Fax:626-287-1991
Practice Address - Street 1:1026 E LAS TUNAS DRIVE
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1633
Practice Address - Country:US
Practice Address - Phone:626-287-7222
Practice Address - Fax:626-287-1991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG69510174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D0930021OtherCLIA WAIVER