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DZEBOLO MD GROUP INC
NPI 1023482007
Specialist in Los Angeles, CA

Active since November 13, 2015
2105 BEVERLY BLVD STE 111, LOS ANGELES, CA 90057(213) 484-3994(213) 484-8795 Get Directions Write a Review

NPPES record last updated: November 16, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 16, 2015, Nov 13, 2015 (2 updates tracked since 2015).

About Dzebolo Md Group Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DZEBOLO MD GROUP INC (NPI 1023482007) is a healthcare organization registered as a specialist in Los Angeles, California and active in the NPI registry since November 2015. The organization lists Nicholas N Dzebolo, Owner, as its authorized official.

NPPES Registry Identity

NPI1023482007
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameDZEBOLO MD GROUP INC
Location Address2105 BEVERLY BLVD STE 111Los Angeles, CA 90057-2252
Mailing Address1100 Ridgeside DrMonterey Park, CA 91754-3731 · (626) 281-6442 · Fax (888) 302-2447
Phone(213) 484-3994
Fax(213) 484-8795
Organization SubpartNo
Authorized OfficialNicholas N DzeboloOwner · (213) 484-3994
Enumeration DateNovember 13, 2015
Last NPPES UpdateNovember 16, 20152 updates tracked since enumeration
✔ NPI 1023482007 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CA · 6036396
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
2105 BEVERLY BLVD STE 111, Los Angeles, CA 90057
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Other Identifiers 1

Medicare UPINA46671CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dzebolo MD Group Inc's NPI number?

The NPI number for Dzebolo MD Group Inc is 1023482007. It was assigned to this organization in the NPPES registry on November 13, 2015.

Where is Dzebolo MD Group Inc located?

Dzebolo MD Group Inc is located at 2105 Beverly Blvd Ste 111, Los Angeles, CA 90057. The listed phone number is (213) 484-3994.

What is Dzebolo MD Group Inc's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Dzebolo MD Group Inc was last updated on November 16, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.