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General NPI Number Information
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NPI Number | 1598154478
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Entity Type | Individual
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Provider Name | TAQIALDEEN ZAMIL PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 1310 W STEWART DR STE 301
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City | ORANGE
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State | CA
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Zip | 92868-3838
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Country | US
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Telephone | 714-712-0711
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Fax | 657-224-4781
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Provider Business Mailing Address
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Address Line | 101 S BILLIE JO CIR
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City | ANAHEIM
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State | CA
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Zip | 92806-3101
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Country | US
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Telephone | 714-248-3764
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Fax | 512-521-0386
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 03557
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95003782
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License Number State | CA
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