Provider Demographics
NPI:1548833692
Name:KAMAL ZAKKA MD AN OPHTHALMOLOGICAL CORP
Entity type:Organization
Organization Name:KAMAL ZAKKA MD AN OPHTHALMOLOGICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAMAL
Authorized Official - Middle Name:AMAL
Authorized Official - Last Name:ZAKKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-270-5493
Mailing Address - Street 1:10724 WILSHIRE BLVD APT 1209
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-4473
Mailing Address - Country:US
Mailing Address - Phone:310-270-5493
Mailing Address - Fax:
Practice Address - Street 1:9100 WILSHIRE BLVD STE 265E
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3440
Practice Address - Country:US
Practice Address - Phone:800-444-5241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty