Healthcare Provider Details

I. General information

NPI: 1437322518
Provider Name (Legal Business Name): BIHON ZEWELDEMARIAM NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 W COLE BLVD
CALEXICO CA
92231-9722
US

IV. Provider business mailing address

223 W COLE BLVD
CALEXICO CA
92231-9722
US

V. Phone/Fax

Practice location:
  • Phone: 730-357-2020
  • Fax: 760-357-1056
Mailing address:
  • Phone: 730-357-2020
  • Fax: 760-357-1056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA19560
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: