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General NPI Number Information
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NPI Number | 1053020396
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Entity Type | Individual
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Provider Name | ZAHUR-AKHTAR SUBEDAR
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Gender | Male
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Dates
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Enumeration Date | 11/15/2022
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 1821 SANTA CLARA AVE
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City | ALAMEDA
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State | CA
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Zip | 94501-2666
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Country | US
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Telephone | 650-278-7982
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Fax |
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Provider Business Mailing Address
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Address Line | 3770 CALLAN BLVD
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-5125
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 107929
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License Number State | CA
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