Provider Demographics
NPI:1619937158
Name:CHOBANOV, ZELJKA (MD)
Entity Type:Individual
Prefix:DR
First Name:ZELJKA
Middle Name:
Last Name:CHOBANOV
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 1:520 EATON AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-2716
Mailing Address - Country:US
Mailing Address - Phone:937-643-9299
Mailing Address - Fax:937-643-2343
Practice Address - Street 1:520 EATON AVE STE 102
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-2716
Practice Address - Country:US
Practice Address - Phone:937-643-9299
Practice Address - Fax:937-643-2343
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000459302084N0400X
CAC551682084N0400X
OH35.1364542084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0363309Medicaid
CA1619937158Medicaid
WA0207955OtherL&I/CRIME VICTIMS
WA8446825Medicaid