1760461131 NPI number — MRS. ANASTACIA MARIA ZOUMBERAKIS MS, CGC

Table of content: MRS. ANASTACIA MARIA ZOUMBERAKIS MS, CGC (NPI 1760461131)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760461131 NPI number — MRS. ANASTACIA MARIA ZOUMBERAKIS MS, CGC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZOUMBERAKIS
Provider First Name:
ANASTACIA
Provider Middle Name:
MARIA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS, CGC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760461131
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10525 PANGBORN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DOWNEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90241-2937
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-861-8388
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9449 IMPERIAL HWY
Provider Second Line Business Practice Location Address:
SUITE D472
Provider Business Practice Location Address City Name:
DOWNEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90242-2814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-657-2772
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 170300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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