Provider Demographics
NPI:1396777538
Name:KAYALI, ZEID K (MD)
Entity type:Individual
Prefix:
First Name:ZEID
Middle Name:K
Last Name:KAYALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 N RIVERSIDE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92377-4697
Mailing Address - Country:US
Mailing Address - Phone:909-883-2999
Mailing Address - Fax:909-883-2997
Practice Address - Street 1:2006 N RIVERSIDE AVE STE A
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92377-4697
Practice Address - Country:US
Practice Address - Phone:909-883-2999
Practice Address - Fax:909-883-2997
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71164207RG0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0100430OtherGROUP MEDICAL
CA1902846306OtherGROUP NPI
CA00A711640Medicaid
CAW18762OtherGROUP MEDICARE
CAW18762OtherGROUP MEDICARE
CA00A711640Medicaid