Provider Demographics
NPI:1043497860
Name:ZADEH, HAMID TAVAKOLI (MD)
Entity Type:Individual
Prefix:DR
First Name:HAMID
Middle Name:TAVAKOLI
Last Name:ZADEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2435 MARSHALL RD
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:CA
Mailing Address - Zip Code:92251-9599
Mailing Address - Country:US
Mailing Address - Phone:760-550-6327
Mailing Address - Fax:
Practice Address - Street 1:2435 MARSHALL RD
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:CA
Practice Address - Zip Code:92251-9599
Practice Address - Country:US
Practice Address - Phone:760-550-6327
Practice Address - Fax:760-550-6331
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101245174400000X, 207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No174400000XOther Service ProvidersSpecialist