Provider Demographics
NPI:1477703569
Name:ZIAEE, HOSSEINGHOLI (MD)
Entity Type:Individual
Prefix:
First Name:HOSSEINGHOLI
Middle Name:
Last Name:ZIAEE
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 1:44215 15TH ST W
Mailing Address - Street 2:SUITE 115
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4014
Mailing Address - Country:US
Mailing Address - Phone:661-949-5929
Mailing Address - Fax:661-949-5083
Practice Address - Street 1:44215 15TH ST W
Practice Address - Street 2:SUITE 115
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4014
Practice Address - Country:US
Practice Address - Phone:661-949-5929
Practice Address - Fax:661-949-5083
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA89604207ZP0101X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology