Basic Information
Provider Information
NPI: 1366869216
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NEVO
FirstName: ZEV
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3010 BEARD RD
Address2:  
City: NAPA
State: CA
PostalCode: 945583442
CountryCode: US
TelephoneNumber: 7072558825
FaxNumber: 7072559325
Practice Location
Address1: 4849 VAN NUYS BLVD STE 202
Address2:  
City: SHERMAN OAKS
State: CA
PostalCode: 914032110
CountryCode: US
TelephoneNumber: 8188176377
FaxNumber: 7473897005
Other Information
ProviderEnumerationDate: 03/27/2014
LastUpdateDate: 06/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/22/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208100000X20A16400CAY Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 

No ID Information.


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