Healthcare Provider Details

I. General information

NPI: 1730010372
Provider Name (Legal Business Name): ZAID AHMED RIDHA MALALLAH DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3125 VISTA WAY
OCEANSIDE CA
92056-3630
US

IV. Provider business mailing address

PO BOX 1201
EL CAJON CA
92022-1201
US

V. Phone/Fax

Practice location:
  • Phone: 761-828-9223
  • Fax:
Mailing address:
  • Phone: 619-504-9490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number112963
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: