# CSI PHYSICAN & MEDICAL SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ZAK MEDICAL CORP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1124411400
- **Legal business name:** ZAK MEDICAL CORP
- **Authorized official:** TAMARA SULLIVAN (MANAGER)
- **Authorized official phone:** (760) 837-0364

## Contact information

- **Practice address:** 73710 ALESSANDRO DR., BLD CT A1, PALM DESERT, CA 92260
- **Practice address phone:** (760) 837-0364
- **Practice address fax:** (760) 837-3843
- **Mailing address:** P.O. BOX 533, PALM DESERT, CA 92260
- **Mailing address phone:** (760) 837-0364
- **Mailing address fax:** (760) 837-3843

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | A61113 | CA | Yes |

## Other

- **Enumeration date:** 03/11/2015
- **Last updated:** 03/11/2015