Provider Demographics
NPI:1932688017
Name:GHABRA, ZIYAD (MD)
Entity Type:Individual
Prefix:DR
First Name:ZIYAD
Middle Name:
Last Name:GHABRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ZIYAD
Other - Middle Name:A
Other - Last Name:GHABRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8840 COSTA VERDE BLVD APT 3447
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-6630
Mailing Address - Country:US
Mailing Address - Phone:858-776-9152
Mailing Address - Fax:
Practice Address - Street 1:250 N 1ST ST
Practice Address - Street 2:
Practice Address - City:BLYTHE
Practice Address - State:CA
Practice Address - Zip Code:92225-1702
Practice Address - Country:US
Practice Address - Phone:858-776-9152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC40841207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology