Provider Demographics
NPI:1003202920
Name:ZEBARJADI, OMID (DO)
Entity Type:Individual
Prefix:
First Name:OMID
Middle Name:
Last Name:ZEBARJADI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27819 SAGEBRUSH RD
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92585-4002
Mailing Address - Country:US
Mailing Address - Phone:415-827-1483
Mailing Address - Fax:
Practice Address - Street 1:27699 JEFFERSON AVE STE 305
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-2615
Practice Address - Country:US
Practice Address - Phone:951-503-8730
Practice Address - Fax:714-410-0369
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14885207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine