Healthcare Provider Details

I. General information

NPI: 1164054383
Provider Name (Legal Business Name): ZAHRA H PERFECT WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2020
Last Update Date: 10/27/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 WESTERN AVE STE 204
SAN BERNARDINO CA
92411-1353
US

IV. Provider business mailing address

1800 WESTERN AVE STE 204
SAN BERNARDINO CA
92411-1353
US

V. Phone/Fax

Practice location:
  • Phone: 909-474-9952
  • Fax: 909-474-9951
Mailing address:
  • Phone: 909-474-9952
  • Fax: 909-474-9951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number95013901
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: