Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A141965 | CA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | A141965 | CA |
NPI | 1053602292 |
---|---|
Provider Name | Dr. Ali M Maziad |
First Address | Thousand Oaks, CA 91320 |
Second Address | Thousand Oaks, CA 91320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2011 |
Last Update Date | 31/01/2017 |