Provider Demographics
NPI:1154425551
Name:DANIELZADEH, JAMES ALBERT (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALBERT
Last Name:DANIELZADEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:18370 BURBANK BLVD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2804
Mailing Address - Country:US
Mailing Address - Phone:818-881-5661
Mailing Address - Fax:
Practice Address - Street 1:18370 BURBANK BLVD STE 209
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2855
Practice Address - Country:US
Practice Address - Phone:818-881-5661
Practice Address - Fax:818-881-6132
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG085175207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38806-020OtherWISCONSIN MEDICAL LICENSE
CAG085175OtherCALIFORNIA LICENSE
CAG085175OtherCALIFORNIA LICENSE