Healthcare Provider Details

I. General information

NPI: 1295171908
Provider Name (Legal Business Name): PEYMAN ZAMAN SAMGHABADI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2013
Last Update Date: 06/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR LANE BLVD L235
PALO ALTO CA
94305
US

IV. Provider business mailing address

300 PASTEUR DR LANE BLVD L235
PALO ALTO CA
94305
US

V. Phone/Fax

Practice location:
  • Phone: 650-725-8383
  • Fax:
Mailing address:
  • Phone: 650-725-8383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZN0500X
TaxonomyNeuropathology Physician
License NumberA132309
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberA132309
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: