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NPI Code Detail

MEDICARE: DINA ZAYOUR EZZEDDINE M.D.

MEDICARE: DINA ZAYOUR EZZEDDINE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist35073769EOH
2207RG0100XGastroenterology PhysicianC137543CA

General Provider Information

NPI Number : 1598749715
Entity Type Code : Individual
Provider Name (Legal Business Name) : DINA ZAYOUR EZZEDDINE M.D.
Provider Business Mailing Address
First Line : 3687 MT DIABLO BLVD
Second Line : SUITE 200
City : LAFAYETTE
State : CA
Zip : 94549-3717
Country : US
Telephone Number : 701-530-6000
Fax Number : 701-530-6407
Provider Business Practice Location Address
First Line : 3687 MT DIABLO BLVD
Second Line : SUITE 200
City : LAFAYETTE
State : CA
Zip : 94549-3717
Country : US
Telephone Number : 701-530-6000
Fax Number : 701-530-6407
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2005
Last Update Date : 08/20/2015

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