Provider Demographics
NPI:1033374293
Name:RHAYEM, ZIAD G
Entity Type:Individual
Prefix:DR
First Name:ZIAD
Middle Name:G
Last Name:RHAYEM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21123 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-2828
Mailing Address - Country:US
Mailing Address - Phone:818-888-2700
Mailing Address - Fax:818-888-8317
Practice Address - Street 1:21123 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-2828
Practice Address - Country:US
Practice Address - Phone:818-888-2700
Practice Address - Fax:818-888-8317
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-26
Last Update Date:2008-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36421122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist