Organization
DZEBOLO MD GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS N DZEBOLO MD (OWNER)
(213) 484-3994
Entity
Organization
Contact information
Practice address
2105 BEVERLY BLVD STE 111, LOS ANGELES, CA 90057-2252
(213) 484-3994
(213) 484-8795
Mailing address
1100 RIDGESIDE DR, MONTEREY PARK, CA 91754-3731
(626) 281-6442
(888) 302-2447
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6036396
CA
Other
Enumeration date
11/13/2015
Last updated
11/16/2015
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