MEDICARE: SHOBI ZAIDI MD INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0200X	Radiology Clinic/Center
2	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1215333158
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHOBI ZAIDI MD INC.

Provider Business Mailing Address
First Line	:	12523 LIMONITE AVE
Second Line	:	440-353
City	:	MIRA LOMA
State	:	CA
Zip	:	91752-3665
Country	:	US
Telephone Number	:	888-480-9996
Fax Number	:

Provider Business Practice Location Address
First Line	:	12523 LIMONITE AVE # 440-353
Second Line	:
City	:	EASTVALE
State	:	CA
Zip	:	91752-3665
Country	:	US
Telephone Number	:	888-480-9996
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SHOBI ZAIDI
Credential	:	M.D.
Telephone Number	:	888-480-9996

Provider Enumeration Date	:	11/04/2014
Last Update Date	:	06/11/2021

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