MEDICARE: ZAHRA KARDOS RN, PHN, WHNP-BC

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
1	363LW0102X	Women's Health Nurse Practitioner	95019097	CA
2	163W00000X	Registered Nurse	775130	CA

General Provider Information

NPI Number	:	1962739862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZAHRA KARDOS RN, PHN, WHNP-BC

Provider Business Mailing Address
First Line	:	5694 MISSION CENTER RD, STE 602-208
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-4312
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5694 MISSION CENTER RD, STE 602-208
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-4312
Country	:	US
Telephone Number	:	619-987-0803
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2009
Last Update Date	:	02/10/2022

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