Healthcare Provider Details

I. General information

NPI: 1427296136
Provider Name (Legal Business Name): AJAAZ AHMED ZARGAR CP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2009
Last Update Date: 02/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 E COMMONWEALTH AVE
FULLERTON CA
92832-2017
US

IV. Provider business mailing address

332 E COMMONWEALTH AVE
FULLERTON CA
92832-2017
US

V. Phone/Fax

Practice location:
  • Phone: 714-738-4769
  • Fax: 714-871-4816
Mailing address:
  • Phone: 714-738-4769
  • Fax: 714-871-4816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: