Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 930083 | CA |
N | 111NI0900X | Internist | 930083 | CA |
N | 207RH0000X | Hematologist | 930083 | CA |
Y | 207RH0003X | Hematology & Oncology | 930083 | CA |
N | 207RX0202X | Medical Oncology | 930083 | CA |
NPI | 1144412560 |
---|---|
Provider Name | Zeyad Hashem Kanaan |
First Address | Mountain View, CA 94040-6203 |
Second Address | Santa Rosa, CA 95403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2007 |
Last Update Date | 04/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A157617 | STATE MEDICAL LICENSE (01) | CA |
FK2083183 | FEDERAL DEA LICENSE (01) | CA |