Provider Demographics
NPI:1114998903
Name:NIAZI, ZIAD A (MD)
Entity Type:Individual
Prefix:
First Name:ZIAD
Middle Name:A
Last Name:NIAZI
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:PO BOX 496084
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96049-6084
Mailing Address - Country:US
Mailing Address - Phone:530-241-0473
Mailing Address - Fax:530-241-5377
Practice Address - Street 1:1760 GOLD ST
Practice Address - Street 2:STE 500
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1806
Practice Address - Country:US
Practice Address - Phone:530-244-9332
Practice Address - Fax:530-244-0859
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35335208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A353350Medicaid
CA00A353350Medicare ID - Type Unspecified
CA00A353350Medicaid