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General NPI Number Information
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NPI Number | 1265147011
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Entity Type | Organization
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Legal Business Name | MARIYA A ZAKIUDDIN, MD, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/17/2023
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Last Update Date | 01/17/2023
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Provider Practice Location Address
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Address Line | 500 E OLIVE AVE STE 240
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City | BURBANK
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State | CA
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Zip | 91501-2171
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Country | US
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Telephone | 818-391-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 500 E OLIVE AVE STE 240
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City | BURBANK
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State | CA
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Zip | 91501-2171
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Country | US
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Telephone | 818-391-2400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARIYA ZAKIUDDIN
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Credential | MD
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Telephone | 630-605-0630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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