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1306839915

NPI Code Detail

MEDICARE: ZAHORA NICOLA ALLY MD

MEDICARE: ZAHORA NICOLA ALLY MD

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	2085R0001X	Radiation Oncology Physician	ME89834	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	16428	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1306839915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZAHORA NICOLA ALLY MD

Provider Business Mailing Address
First Line	:	6380 CLARK AVE
Second Line	:
City	:	DUBLIN
State	:	CA
Zip	:	94568-3036
Country	:	US
Telephone Number	:	925-875-1677
Fax Number	:	925-875-0826

Provider Business Practice Location Address
First Line	:	4721 DALLAS RANCH RD
Second Line	:
City	:	ANTIOCH
State	:	CA
Zip	:	94531-8811
Country	:	US
Telephone Number	:	925-778-0679
Fax Number	:	925-778-3567

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	05/13/2013

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Directions to “ ZAHORA NICOLA ALLY MD” Practice Location

Language	Start Address	Practice Location

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