Provider Demographics
NPI:1477629475
Name:ZAKI LABABIDI MD SC
Entity Type:Organization
Organization Name:ZAKI LABABIDI MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAKI
Authorized Official - Middle Name:
Authorized Official - Last Name:LABABIDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-786-9100
Mailing Address - Street 1:3505 S. MERCY ROAD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-0427
Mailing Address - Country:US
Mailing Address - Phone:480-786-9100
Mailing Address - Fax:480-786-0742
Practice Address - Street 1:3505 S. MERCY ROAD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-0427
Practice Address - Country:US
Practice Address - Phone:480-786-9100
Practice Address - Fax:480-786-0742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32146207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZF22847Medicare UPIN