Provider Demographics
NPI:1396319992
Name:MYLES ZAKHEIM
Entity type:Organization
Organization Name:MYLES ZAKHEIM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MYLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAKHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:310-709-2759
Mailing Address - Street 1:416 N FAIRFAX AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-1717
Mailing Address - Country:US
Mailing Address - Phone:310-597-9997
Mailing Address - Fax:323-917-5032
Practice Address - Street 1:632 BROADWAY STE Z
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-2614
Practice Address - Country:US
Practice Address - Phone:212-432-5847
Practice Address - Fax:516-866-0794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-18
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty