Organization
NIFTY AFTER FIFTY - PROSPECT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELDON S. ZINBERG M.D. (CEO)
(714) 823-4400
Entity
Organization
Contact information
Practice address
11021 BROOKHURST ST, SUITE A, GARDEN GROVE, CA 92840-1001
(714) 823-4400
(714) 823-4404
Mailing address
12572 VALLEY VIEW ST, GARDEN GROVE, CA 92845-2006
(714) 823-4400
(714) 823-4404
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
PT11479
CA
208100000X
Physical Medicine & Rehabilitation Physician
PT22690
CA
208100000X
Physical Medicine & Rehabilitation Physician
PT28267
CA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT29179
CA
208100000X
Physical Medicine & Rehabilitation Physician
PT7788
CA
Other
Enumeration date
06/13/2007
Last updated
08/22/2020
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