Individual
VITALIY ZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
44139 MONTEREY AVE STE A, PALM DESERT, CA 92260-8700
(760) 469-5195
Mailing address
44139 MONTEREY AVE STE A, PALM DESERT, CA 92260-8700
(800) 898-2020
(844) 897-3788
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00044090
WA
207W00000X
Ophthalmology Physician
Primary
C193067
CA
207W00000X
Ophthalmology Physician
S6335
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669566535
—
CA
05
—
8408023
—
WA
Enumeration date
10/03/2006
Last updated
04/22/2024
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