Provider Demographics
NPI:1568865962
Name:ZIA A DEHQANZADA MD APC
Entity Type:Organization
Organization Name:ZIA A DEHQANZADA MD APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZIA
Authorized Official - Middle Name:AHMAD
Authorized Official - Last Name:DEHQANZADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-932-4675
Mailing Address - Street 1:2 MEDICAL PLAZA DR
Mailing Address - Street 2:#275
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3043
Mailing Address - Country:US
Mailing Address - Phone:916-797-7534
Mailing Address - Fax:
Practice Address - Street 1:2 MEDICAL PLAZA DR
Practice Address - Street 2:#275
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3043
Practice Address - Country:US
Practice Address - Phone:916-797-7534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1187452086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Single Specialty