Healthcare Provider Details

I. General information

NPI: 1306028907
Provider Name (Legal Business Name): ZAID NOMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2007
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 E 17TH ST
COSTA MESA CA
92627-3792
US

IV. Provider business mailing address

131 E 17TH ST
COSTA MESA CA
92627-3792
US

V. Phone/Fax

Practice location:
  • Phone: 949-548-8400
  • Fax: 949-548-1214
Mailing address:
  • Phone: 949-548-8400
  • Fax: 949-548-1214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA101666
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA101666
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: