Provider Demographics
NPI:1912250358
Name:A. M. MEMAR-ZIA MD INC.
Entity Type:Organization
Organization Name:A. M. MEMAR-ZIA MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDOL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEMAR-ZIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:805-527-6666
Mailing Address - Street 1:1687 ERRINGER RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-6508
Mailing Address - Country:US
Mailing Address - Phone:805-527-6666
Mailing Address - Fax:805-527-2212
Practice Address - Street 1:1687 ERRINGER RD
Practice Address - Street 2:SUITE 205
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-6508
Practice Address - Country:US
Practice Address - Phone:805-527-6666
Practice Address - Fax:805-527-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-23
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33418207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C03919Medicare UPIN