Provider Demographics
NPI:1881699171
Name:ZIYAR, LATIF (MD)
Entity type:Individual
Prefix:
First Name:LATIF
Middle Name:
Last Name:ZIYAR
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 1:1702 E UTAH AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-1967
Mailing Address - Country:US
Mailing Address - Phone:559-449-1209
Mailing Address - Fax:559-449-1299
Practice Address - Street 1:7335 N 1ST ST
Practice Address - Street 2:STE 109
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2968
Practice Address - Country:US
Practice Address - Phone:559-449-1209
Practice Address - Fax:559-449-1299
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2012-11-29
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
CAA55320174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist