Healthcare Provider Details

I. General information

NPI: 1245278399
Provider Name (Legal Business Name): IRAJ ZAMANIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ALEXANDER ZAMANIAN

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3036 SANTA FE AVE
LONG BEACH CA
90810-2744
US

IV. Provider business mailing address

3036 SANTA FE AVE
LONG BEACH CA
90810-2744
US

V. Phone/Fax

Practice location:
  • Phone: 562-591-2785
  • Fax: 562-591-2890
Mailing address:
  • Phone: 562-591-2785
  • Fax: 562-591-2890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA42243
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: