Provider Demographics
NPI:1568446979
Name:ZENOOZ, ASHWINI MYSORE (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHWINI
Middle Name:MYSORE
Last Name:ZENOOZ
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 1:806 CLARA DR
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-3909
Mailing Address - Country:US
Mailing Address - Phone:650-391-9705
Mailing Address - Fax:
Practice Address - Street 1:806 CLARA DR
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-3909
Practice Address - Country:US
Practice Address - Phone:650-391-9705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2203572085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ27403OtherBCBS MA
MA2064651Medicaid
MA469115OtherTUFTS HEALTH PLAN
MAA36919Medicare ID - Type Unspecified
I08971Medicare UPIN