Basic Information
| Provider Information | |||||||||
| NPI: | 1588927248 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZELKEN | ||||||||
| FirstName: | KATHY | ||||||||
| MiddleName: | ZHANG | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 DOVER DR STE 7 | ||||||||
| Address2: | |||||||||
| City: | NEWPORT BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926635721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9496454670 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 505 S MAIN ST | ||||||||
| Address2: | SUITE 525 | ||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928684509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144565631 | ||||||||
| FaxNumber: | 7142850389 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2012 | ||||||||
| LastUpdateDate: | 05/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | A130648 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.