Basic Information
| Provider Information | |||||||||
| NPI: | 1528019205 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LUTSKY | ||||||||
| FirstName: | ZACHARY | ||||||||
| MiddleName: | H. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4929 VAN NUYS BLVD | ||||||||
| Address2: | |||||||||
| City: | SHERMAN OAKS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914031702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189817111 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11349 ELDERWOOD ST | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900493030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3107219644 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2006 | ||||||||
| LastUpdateDate: | 09/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | A84668 | CA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.