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

Dzebolo MD Group Inc

Organization Specialist · NPI 1023482007

Dzebolo MD Group Inc is a Specialist 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
Phone: (213) 484-3994
Fax: (213) 484-8795
Show map & directions

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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