Healthcare Provider Details

I. General information

NPI: 1740911031
Provider Name (Legal Business Name): ZAID SALEM ALFALAHI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2022
Last Update Date: 06/18/2022
Certification Date: 06/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 FRIENDLY CIR
EL CAJON CA
92021-6103
US

IV. Provider business mailing address

845 FRIENDLY CIR
EL CAJON CA
92021-6103
US

V. Phone/Fax

Practice location:
  • Phone: 161-979-2822
  • Fax:
Mailing address:
  • Phone: 161-979-2822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberF7593170
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: