Healthcare Provider Details

I. General information

NPI: 1316117955
Provider Name (Legal Business Name): TOURAN M ZADEH MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2008
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 SOUTH MAIN STREET SUITE E
ORANGE CA
92868
US

IV. Provider business mailing address

211 SOUTH MAIN STREET SUITE E
ORANGE CA
92868
US

V. Phone/Fax

Practice location:
  • Phone: 714-288-3500
  • Fax: 714-288-3510
Mailing address:
  • Phone: 714-288-3500
  • Fax: 714-288-3510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License NumberA32610
License Number StateCA

VIII. Authorized Official

Name: DR. TOURAN M ZADEH
Title or Position: MEDICAL DIRECTOR CEO
Credential:
Phone: 714-288-3500