Healthcare Provider Details

I. General information

NPI: 1487400719
Provider Name (Legal Business Name): SHAFIQ ZAIB ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2024
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 SANTA MONICA BLVD
LOS ANGELES CA
90067-7000
US

IV. Provider business mailing address

BOX 100
YOUNGSTOWN ALBERTA
T0J3P0
CA

V. Phone/Fax

Practice location:
  • Phone: 917-916-9002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number000311
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: