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Organization

NICK DZEBOLO MD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICHOLAS N DZEBOLO MD (CEO)
(818) 241-5072
Entity
Organization

Contact information

Practice address
1030 S GLENDALE AVE, SUITE 200, GLENDALE, CA 91205-2866
(818) 241-5072
(818) 244-1768
Mailing address
1030 S GLENDALE AVE, SUITE 200, GLENDALE, CA 91205-2866
(818) 241-5072
(818) 244-1768

Taxonomy

Speciality
Code
Description
License number
State
207UN0901X
Nuclear Cardiology Physician
2085R0202X
Diagnostic Radiology Physician
Primary
2085R0204X
Vascular & Interventional Radiology Physician

Other

Enumeration date
11/22/2010
Last updated
11/22/2010
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