Healthcare Provider Details

I. General information

NPI: 1083752018
Provider Name (Legal Business Name): DARIUSH ZANDI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 12/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13851 E 14TH ST STE 102
SAN LEANDRO CA
94578-2628
US

IV. Provider business mailing address

13851 E 14TH ST STE 102
SAN LEANDRO CA
94578-2628
US

V. Phone/Fax

Practice location:
  • Phone: 510-351-2100
  • Fax: 510-357-3389
Mailing address:
  • Phone: 510-351-2100
  • Fax: 510-357-3389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: YVONNE BELL
Title or Position: MEDICAL BILLER
Credential:
Phone: 510-351-2100