Healthcare Provider Details

I. General information

NPI: 1225039183
Provider Name (Legal Business Name): ZAKI LABABIDI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3505 S MERCY RD
GILBERT AZ
85297-0427
US

IV. Provider business mailing address

PO BOX 20490
MESA AZ
85277-0490
US

V. Phone/Fax

Practice location:
  • Phone: 480-786-9100
  • Fax: 480-786-0742
Mailing address:
  • Phone: 480-985-1093
  • Fax: 480-296-7665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number32146
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number32146
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number32146
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: