Provider Demographics
NPI:1811941628
Name:MAJZOUBI, DARIA (MD)
Entity type:Individual
Prefix:DR
First Name:DARIA
Middle Name:
Last Name:MAJZOUBI
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 1:1524 W. LACEY BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230
Mailing Address - Country:US
Mailing Address - Phone:559-583-4697
Mailing Address - Fax:559-583-4600
Practice Address - Street 1:1524 W. LACEY BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230
Practice Address - Country:US
Practice Address - Phone:559-583-4509
Practice Address - Fax:559-583-4655
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85143207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I00252Medicare UPIN
00A851431Medicare ID - Type Unspecified