Provider Demographics
NPI:1386808673
Name:ZAKER, MEYSAM (MEYSAM ZAKER)
Entity type:Individual
Prefix:DR
First Name:MEYSAM
Middle Name:
Last Name:ZAKER
Suffix:
Gender:M
Credentials:MEYSAM ZAKER
Other - Prefix:DR
Other - First Name:MEYSAM
Other - Middle Name:
Other - Last Name:ZAKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MEYSAM ZAKER
Mailing Address - Street 1:3204 DANAHA ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6925
Mailing Address - Country:US
Mailing Address - Phone:310-325-2015
Mailing Address - Fax:
Practice Address - Street 1:2470 S. WESTERN AVE
Practice Address - Street 2:SAN PEDRO
Practice Address - City:CA
Practice Address - State:CA
Practice Address - Zip Code:90732
Practice Address - Country:US
Practice Address - Phone:424-224-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57220122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist