Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | A107500 | CA |
NPI | 1225253099 |
---|---|
Provider Name | Faraz Raza Zaidi |
First Address | Granite Bay, CA 95746-2074 |
Second Address | Carmichael, CA 95608-0400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 17/03/2018 |