Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | A138224 | CA |
N | 207QA0401X | Family Doctor - Addiction Medicine | A138224 | CA |
N | 208D00000X | General Practice Physician | A138224 | CA |
NPI | 1063779163 |
---|---|
Provider Name | Dr. Marco M Zahedi |
First Address | Irvine, CA 92606-8291 |
Second Address | Santa Ana, CA 92705-6502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2012 |
Last Update Date | 07/01/2021 |