Provider Demographics
NPI:1164428942
Name:ZAREHBIN, PAYAM (OD)
Entity Type:Individual
Prefix:DR
First Name:PAYAM
Middle Name:
Last Name:ZAREHBIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 E 12TH ST
Mailing Address - Street 2:STE 109
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-2943
Mailing Address - Country:US
Mailing Address - Phone:510-533-6567
Mailing Address - Fax:510-533-6566
Practice Address - Street 1:3301 E 12TH ST
Practice Address - Street 2:STE 109
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-2943
Practice Address - Country:US
Practice Address - Phone:510-533-6567
Practice Address - Fax:510-533-6566
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-25
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11992 TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0119920Medicaid
SD0119923Medicare ID - Type Unspecified
CASD0119920Medicaid