Basic Information
| Provider Information | |||||||||
| NPI: | 1710197140 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JAMES P ZALEZ, MD A MEDICAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6029 BRISTOL PKWY STE 100 | ||||||||
| Address2: | |||||||||
| City: | CULVER CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902304899 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104174900 | ||||||||
| FaxNumber: | 3104101001 | ||||||||
| Practice Location | |||||||||
| Address1: | 2001 SANTA MONICA BLVD STE 860 | ||||||||
| Address2: | |||||||||
| City: | SANTA MONICA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 904042189 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108283209 | ||||||||
| FaxNumber: | 3108285165 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2007 | ||||||||
| LastUpdateDate: | 01/25/2010 | ||||||||
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| AuthorizedOfficialLastName: | ZALEZ | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3108283209 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208G00000X | G65652 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
No ID Information.