MEDICARE: DR. ZAID SAAD AL-MULLA 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	208000000X	Pediatrics Physician	MD21712	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558441030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZAID SAAD AL-MULLA MD

Provider Business Mailing Address
First Line	:	9735 SW SHADY LN STE 300
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97223-5481
Country	:	US
Telephone Number	:	503-466-1779
Fax Number	:	503-598-9030

Provider Business Practice Location Address
First Line	:	9735 SW SHADY LN STE 300
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97223-5481
Country	:	US
Telephone Number	:	503-466-1779
Fax Number	:	503-598-9030

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	07/08/2007

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