Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 0101233249 | VA |
Y | 208600000X | Surgeon | 0101233249 | VA |
NPI | 1003015652 |
---|---|
Provider Name | Dr. Zia Ahmad Dehqanzada |
First Address | Woodland, CA 95695-5868 |
Second Address | Apo, AE 09042 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2007 |
Last Update Date | 11/08/2011 |