Provider Demographics
NPI:1174265169
Name:ZADA, ANDRAWIS MAJDI (OD)
Entity Type:Individual
Prefix:
First Name:ANDRAWIS
Middle Name:MAJDI
Last Name:ZADA
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 1:1144 PEBBLEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-4914
Mailing Address - Country:US
Mailing Address - Phone:650-274-1709
Mailing Address - Fax:
Practice Address - Street 1:353 2ND ST
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-4607
Practice Address - Country:US
Practice Address - Phone:530-758-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-10
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program