Provider Demographics
NPI:1114095197
Name:ATAZAI, ZAID (DC)
Entity Type:Individual
Prefix:
First Name:ZAID
Middle Name:
Last Name:ATAZAI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37423 FREMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-3704
Mailing Address - Country:US
Mailing Address - Phone:510-713-1800
Mailing Address - Fax:510-791-0350
Practice Address - Street 1:37423 FREMONT BLVD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-3704
Practice Address - Country:US
Practice Address - Phone:510-713-1800
Practice Address - Fax:510-791-0350
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0240610111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0240610Medicare ID - Type Unspecified