Provider Demographics
NPI:1518920974
Name:HIJAZI, ZEINA (MD)
Entity Type:Individual
Prefix:
First Name:ZEINA
Middle Name:
Last Name:HIJAZI
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 1:1745 11TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-4389
Mailing Address - Country:US
Mailing Address - Phone:661-496-9918
Mailing Address - Fax:
Practice Address - Street 1:1745 11TH ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-4389
Practice Address - Country:US
Practice Address - Phone:661-496-9918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60285207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH70531Medicare UPIN
CA00A602850Medicare ID - Type Unspecified