Provider Demographics
NPI:1003015652
Name:DEHQANZADA, ZIA AHMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:ZIA
Middle Name:AHMAD
Last Name:DEHQANZADA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 REDWING DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-5868
Mailing Address - Country:US
Mailing Address - Phone:916-817-7268
Mailing Address - Fax:
Practice Address - Street 1:CMR 442
Practice Address - Street 2:BOX 291
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09042
Practice Address - Country:US
Practice Address - Phone:49622-117-3440
Practice Address - Fax:49622-117-3427
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101233249208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery