Provider Demographics
NPI:1770014367
Name:ZAMAN, AMBREEN (PA)
Entity Type:Individual
Prefix:
First Name:AMBREEN
Middle Name:
Last Name:ZAMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:AMBREEN
Other - Middle Name:
Other - Last Name:QURESHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:200 PORTER DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1587
Mailing Address - Country:US
Mailing Address - Phone:925-362-2166
Mailing Address - Fax:855-574-3055
Practice Address - Street 1:3315 BROADWAY
Practice Address - Street 2:STREET LEVEL
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5717
Practice Address - Country:US
Practice Address - Phone:510-486-2300
Practice Address - Fax:510-486-2333
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2017-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA54286363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical