Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | A149208 | CA |
N | 208200000X | Surgeon | 125060132 | IL |
N | 208600000X | Surgeon | 125060132 | IL |
NPI | 1275828246 |
---|---|
Provider Name | Dr. Shannon Maria Zielsdorf |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033-5313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2011 |
Last Update Date | 11/09/2020 |