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General NPI Number Information
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NPI Number | 1962931964
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Entity Type | Individual
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Provider Name | JOHN R. ZADE M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/05/2017
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Last Update Date | 07/01/2024
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Provider Practice Location Address
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Address Line | 1079 W 23RD ST
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City | YUMA
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State | AZ
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Zip | 85364-8347
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Country | US
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Telephone | 928-247-6825
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Fax | 928-247-6827
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Provider Business Mailing Address
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Address Line | 2285 CORPORATE CIR STE 200
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City | HENDERSON
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State | NV
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Zip | 89074-7759
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Country | US
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Telephone | 702-360-2763
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Fax | 949-783-2880
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 67129
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License Number State | AZ
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