Nick Dzebolo MD Inc

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

NICK DZEBOLO MD INC

Practice address

1030 S Glendale Ave
Suite 200
Glendale, CA 91205-2866

Phone

(818) 241-5072

Fax

(818) 244-1768

NPI assigned

Nov 22, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nicholas N Dzebolo, MD

Title

Ceo

Phone

(818) 241-5072

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290384000000",
    "number": "1205138328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 S GLENDALE AVE",
            "address_2": "SUITE 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912052866",
            "telephone_number": "818-241-5072",
            "fax_number": "818-244-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 S GLENDALE AVE",
            "address_2": "SUITE 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912052866",
            "telephone_number": "818-241-5072",
            "fax_number": "818-244-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICK DZEBOLO MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-22",
        "last_updated": "2010-11-22",
        "status": "A",
        "authorized_official_last_name": "DZEBOLO",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-241-5072",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207UN0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathalie Nguyen, D.O.
• Sandy Nguyen, O.D.
• Thanh The Nguyen, D.O
• Tiffany Nguyen
• Van Nguyen, PHARMD
• Anashe Nicoghosian, M.A.
• Frances Nicolais, CMT
• Kirk Nielsen, PHARMD
• Douglas Christian Nies, PH.D.
• Ysidro Nieto

• Diagnostic Radiology Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.