Basic Information
Provider Information
NPI: 1467722124
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZERHOUNI
FirstName: YASMIN
MiddleName: ANISSA
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 512185
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900510185
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 301 W HUNTINGTON DR STE 400
Address2:  
City: ARCADIA
State: CA
PostalCode: 910073471
CountryCode: US
TelephoneNumber: 6262189840
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/11/2012
LastUpdateDate: 06/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208C00000XA136803CAY Allopathic & Osteopathic PhysiciansColon & Rectal Surgery 
208600000XA136803CAN Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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