Basic Information
Provider Information
NPI: 1245353952
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZHIROFF
FirstName: KATRINE
MiddleName: A.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11480 BROOKSHIRE AVE STE 204
Address2:  
City: DOWNEY
State: CA
PostalCode: 902415023
CountryCode: US
TelephoneNumber: 5629771690
FaxNumber: 5629048836
Practice Location
Address1: 11480 BROOKSHIRE AVE STE 204
Address2:  
City: DOWNEY
State: CA
PostalCode: 902415023
CountryCode: US
TelephoneNumber: 5629771690
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/09/2007
LastUpdateDate: 06/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/15/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0011XA94869CAY Allopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology

No ID Information.


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