Provider Demographics
NPI:1043364433
Name:ZAHED, SHAHROKH (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAHROKH
Middle Name:
Last Name:ZAHED
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 1:6550 KNOTT AVE
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-2612
Mailing Address - Country:US
Mailing Address - Phone:714-522-3333
Mailing Address - Fax:714-522-3085
Practice Address - Street 1:6550 KNOTT AVE
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-2612
Practice Address - Country:US
Practice Address - Phone:714-522-3333
Practice Address - Fax:714-522-3085
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55420261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center