Healthcare Provider Details

I. General information

NPI: 1124726989
Provider Name (Legal Business Name): AHDAD ZIYAR, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N TUSTIN AVE STE 605
SANTA ANA CA
92705-3610
US

IV. Provider business mailing address

7335 N 1ST ST STE 102
FRESNO CA
93720-2968
US

V. Phone/Fax

Practice location:
  • Phone: 714-584-9930
  • Fax:
Mailing address:
  • Phone: 559-449-1209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: AHDAD ZIYAR
Title or Position: PHYSICIAN
Credential: MD
Phone: 213-282-7603