Provider Demographics
NPI:1144274085
Name:EYVAZZADEH, JOHNICA ARBEL (MD)
Entity type:Individual
Prefix:
First Name:JOHNICA
Middle Name:ARBEL
Last Name:EYVAZZADEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 CAMINO RAMON STE 270
Mailing Address - Street 2:MEDICAL ANESTHESIA CONSULTANTS
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4319
Mailing Address - Country:US
Mailing Address - Phone:925-543-0140
Mailing Address - Fax:925-543-0145
Practice Address - Street 1:2420 CAMINO RAMON STE 270
Practice Address - Street 2:MEDICAL ANESTHESIA CONSULTANTS
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4319
Practice Address - Country:US
Practice Address - Phone:925-543-0140
Practice Address - Fax:925-543-0145
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98308207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology