Healthcare Provider Details

I. General information

NPI: 1225480932
Provider Name (Legal Business Name): SYED MOHSIN SHAMIM ZAIDI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2016
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 SANTA ANITA AVE
EL MONTE CA
91733-3411
US

IV. Provider business mailing address

955 LONGVIEW DR
DIAMOND BAR CA
91765-4382
US

V. Phone/Fax

Practice location:
  • Phone: 626-579-7777
  • Fax:
Mailing address:
  • Phone: 810-522-0388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4301110756
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA183418
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: