Organization
CENTRAL MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS N DZEBOLO JR. M.D. (MDICAL DIRECTOR)
(747) 215-6350
Entity
Organization
Contact information
Practice address
710 S CENTRAL AVE STE 310, GLENDALE, CA 91204-4641
(747) 215-6350
(747) 215-6242
Mailing address
710 S CENTRAL AVE STE 310, GLENDALE, CA 91204-4641
(747) 215-6350
(747) 215-6242
Taxonomy
Speciality
Code
Description
License number
State
207UN0901X
Nuclear Cardiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Enumeration date
04/17/2024
Last updated
04/17/2024
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