Individual
GARY D ZEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1450 SAN PABLO STREET, ROOM 2422, LOS ANGELES, CA 90033-5313
(323) 442-2582
(323) 442-2588
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-2582
(323) 442-2588
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G50514
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G505140
BLUE SHIELD
CA
05
—
00G505140
—
CA
01
—
1952325565
GROUP NPI
CA
01
—
220024066
MEDICARE RAILROAD
CA
Enumeration date
07/31/2006
Last updated
02/17/2015
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