Organization
LACEY ZACK, MD INC
Active
Organization
LACEY ZACK, MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACEY ZACK MD (PRESIDENT)
(213) 338-1521
Entity
Organization
Contact information
Practice address
1245 WILSHIRE BLVD STE 607, LOS ANGELES, CA 90017-4806
(213) 338-1521
(213) 266-8183
Mailing address
1245 WILSHIRE BLVD STE 607, LOS ANGELES, CA 90017-4806
(213) 338-1521
(213) 266-8183
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Enumeration date
10/04/2018
Last updated
01/06/2020
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