Provider Demographics
NPI:1649288002
Name:ZAND, ALEX V (MD)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:V
Last Name:ZAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALI
Other - Middle Name:
Other - Last Name:VAZIRIZAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1010 W LA VETA AVE STE 610
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4306
Mailing Address - Country:US
Mailing Address - Phone:714-285-2311
Mailing Address - Fax:714-285-2319
Practice Address - Street 1:1010 W LA VETA AVE
Practice Address - Street 2:STE 610
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4306
Practice Address - Country:US
Practice Address - Phone:714-285-2311
Practice Address - Fax:714-285-2319
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77599207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A75990Medicaid
CAA77599Medicare ID - Type Unspecified
CAH76990Medicare UPIN