Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dzebolo MD Group Inc

Organization Specialist · NPI 1023482007

Dzebolo MD Group Inc provides Specialist services in Los Angeles, California. Licensed in California. Registered with an NPI since 2015.

Licensed in
CA
In the registry since
2015
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2105 Beverly Blvd Ste 111
Los Angeles, CA 90057-2252 Not confirmed with CMS for 10 years — call before visiting
Phone: (213) 484-3994
Fax: (213) 484-8795
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 6036396 (CA)

Record details

NPI number1023482007
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nicholas Dzebolo — Owner · (213) 484-3994
NPI enumeratedNovember 13, 2015
Last updated in NPPESNovember 16, 2015
Mailing address1100 Ridgeside Dr, Monterey Park, CA 91754-3731

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