Doctor Name: | MORTON ZEBRACK |
NPI Number: | 1003943259 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A28654 |
Business Practice Address: | 74976 Us Highway 111 Indian Wells, CA - 922107117 |
Business Phone Number: | 7605684544 |
Business Fax Number: | 7605684555 |
Mailing Address: | 78455 Sunrise Canyon Ave, PALM DESERT |
State: | CA |
Postal Code: | 922112603 |
Phone Number: | 7607725149 |
Fax Number: | 7602004382 |
NPI Enumeration Date: | 02/27/2007 |
NPI Last Update Date: | 03/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A28654 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |