Healthcare Provider Details

I. General information

NPI: 1144274085
Provider Name (Legal Business Name): JOHNICA ARBEL EYVAZZADEH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 PARNASSUS AVE FL 4
SAN FRANCISCO CA
94143-2206
US

IV. Provider business mailing address

2420 CAMINO RAMON STE 270 MEDICAL ANESTHESIA CONSULTANTS
SAN RAMON CA
94583-4319
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-9035
  • Fax:
Mailing address:
  • Phone: 925-543-0140
  • Fax: 925-543-0145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA98308
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: