Healthcare Provider Details

I. General information

NPI: 1871577833
Provider Name (Legal Business Name): MATTHEW M ZAHN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 04/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1719 W 17TH ST
SANTA ANA CA
92706-2316
US

IV. Provider business mailing address

1719 W 17TH ST
SANTA ANA CA
92706-2316
US

V. Phone/Fax

Practice location:
  • Phone: 714-834-8180
  • Fax: 714-834-8196
Mailing address:
  • Phone: 714-834-8180
  • Fax: 714-834-8196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberC55094
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: