Provider Demographics
NPI:1184708745
Name:ZOBER, LAUREL ANN (MD)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:ANN
Last Name:ZOBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11480 BROOKSHIRE AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-5022
Mailing Address - Country:US
Mailing Address - Phone:562-869-2478
Mailing Address - Fax:562-861-1229
Practice Address - Street 1:11480 BROOKSHIRE AVE STE 109
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5022
Practice Address - Country:US
Practice Address - Phone:562-869-2478
Practice Address - Fax:562-861-1229
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG073840174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ98655ZOtherBLUE SHIELD
CAGR0085810Medicaid
CA952682759OtherPROVIDER # FOR MOST INS
CADD1100OtherRAILROAD MEDICARE
CA070008435OtherRAILROAD MEDICARE
CA070008435OtherRAILROAD MEDICARE
CAW1006Medicare ID - Type Unspecified