Provider Demographics
NPI:1275565731
Name:ZIKRIA, GUL A (MD)
Entity Type:Individual
Prefix:
First Name:GUL
Middle Name:A
Last Name:ZIKRIA
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 1:22722 LAMBERT ST STE 1710
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-1618
Mailing Address - Country:US
Mailing Address - Phone:408-946-9453
Mailing Address - Fax:408-946-2756
Practice Address - Street 1:22722 LAMBERT ST STE 1710
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-1618
Practice Address - Country:US
Practice Address - Phone:408-946-9453
Practice Address - Fax:408-946-2756
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G543550174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist