Healthcare Provider Details

I. General information

NPI: 1922318716
Provider Name (Legal Business Name): SHAHNAZ ZAHEDY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2010
Last Update Date: 10/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6234 PASEO ALTA RICO
CARLSBAD CA
92009
US

IV. Provider business mailing address

6234 PASEO ALTA RICO
CARLSBAD CA
92009
US

V. Phone/Fax

Practice location:
  • Phone: 760-672-5504
  • Fax:
Mailing address:
  • Phone: 760-672-5504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number664695
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: