Provider Demographics
NPI:1558342949
Name:SOBHANI, ZINAT (MD)
Entity Type:Individual
Prefix:
First Name:ZINAT
Middle Name:
Last Name:SOBHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHALA
Other - Middle Name:
Other - Last Name:SOBHANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11237 CARMEL CREEK RD UNIT 7
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2629
Mailing Address - Country:US
Mailing Address - Phone:619-992-2714
Mailing Address - Fax:
Practice Address - Street 1:9095 RIO SAN DIEGO DR STE 250
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1699
Practice Address - Country:US
Practice Address - Phone:619-272-0400
Practice Address - Fax:619-272-0503
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-11
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2002-04162084P0800X
CAC536432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM45731331Medicaid
NM45731331Medicaid