Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 115735 | CA |
N | 207YS0123X | Facial Plastic Surgeon | MD60140057 | WA |
NPI | 1780728204 |
---|---|
Provider Name | Dr. Richard A Zoumalan |
First Address | Beverly Hills, CA 90212-2920 |
Second Address | Beverly Hills, CA 90212-2920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 07/10/2011 |