Provider Demographics
NPI:1306839915
Name:ALLY, ZAHORA NICOLA (MD)
Entity Type:Individual
Prefix:
First Name:ZAHORA
Middle Name:NICOLA
Last Name:ALLY
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 1:6380 CLARK AVE
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-3036
Mailing Address - Country:US
Mailing Address - Phone:925-875-1677
Mailing Address - Fax:925-875-0826
Practice Address - Street 1:4721 DALLAS RANCH RD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8811
Practice Address - Country:US
Practice Address - Phone:925-778-0679
Practice Address - Fax:925-778-3567
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME898342085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16428OtherBCBS
FL16428OtherBCBS
FL16428Y (LEESBURG)Medicare PIN
FLP00247665Medicare PIN
FL16428A (CLERMONT)Medicare PIN
FLP00333808Medicare PIN