Healthcare Provider Details

I. General information

NPI: 1063837151
Provider Name (Legal Business Name): ZAHEIB IDREES D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2014
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1161 E COVINA BLVD
COVINA CA
91724
US

IV. Provider business mailing address

PO BOX 1770
LA MESA CA
91944-1770
US

V. Phone/Fax

Practice location:
  • Phone: 714-312-0085
  • Fax: 714-312-0095
Mailing address:
  • Phone: 619-464-1165
  • Fax: 619-567-1011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number20A13624
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: