# ZAGHI MD, A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780137430
- **Authorized official:** DR. SOROUSH ZAGHI M.D. (PHYSICIAN AND SURGEON)
- **Authorized official phone:** (818) 489-2444

## Contact information

- **Practice address:** 5363 BALBOA BLVD, STE 446, ENCINO, CA 91316-2805
- **Practice address phone:** (818) 995-1891
- **Mailing address:** 5363 BALBOA BLVD, STE 446, ENCINO, CA 91316-2805
- **Mailing address phone:** (818) 995-1891

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | NULL | — |
| 103K00000X | Behavior Analyst | — | — | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | NULL | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | — | — |
| 124Q00000X | Dental Hygienist | — | NULL | — |
| 124Q00000X | Dental Hygienist | — | — | — |
| 133NN1002X | Nutrition Education Nutritionist | — | NULL | — |
| 133NN1002X | Nutrition Education Nutritionist | — | — | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | A119458 | CA | — |
| 207Y00000X | Otolaryngology Physician | A119458 | CA | — |
| 207YS0012X | Sleep Medicine (Otolaryngology) Physician | A119458 | CA | Yes |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | A119458 | CA | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 07/29/2016
- **Last updated:** 07/29/2016