Healthcare Provider Details

I. General information

NPI: 1275514986
Provider Name (Legal Business Name): BEHZAD TAGHIZADEH M.D., FACC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 AVOCADO AVE
EL CAJON CA
92020-4604
US

IV. Provider business mailing address

280 AVOCADO AVE
EL CAJON CA
92020-4604
US

V. Phone/Fax

Practice location:
  • Phone: 619-582-2404
  • Fax: 619-243-3236
Mailing address:
  • Phone: 619-582-2404
  • Fax: 619-243-3236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101232582
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberC58208
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number200300293
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: