Provider Demographics
NPI:1861095127
Name:ZOOMDOCTORSONLINE LLC
Entity type:Organization
Organization Name:ZOOMDOCTORSONLINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZARUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:747-400-9002
Mailing Address - Street 1:2730 WILSHIRE BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-4749
Mailing Address - Country:US
Mailing Address - Phone:747-400-9002
Mailing Address - Fax:
Practice Address - Street 1:2730 WILSHIRE BLVD STE 220
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-4749
Practice Address - Country:US
Practice Address - Phone:747-400-9002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care