Provider Demographics
NPI:1912958786
Name:SAWAN, ZIAD RICHARD I (MD)
Entity Type:Individual
Prefix:DR
First Name:ZIAD
Middle Name:RICHARD
Last Name:SAWAN
Suffix:I
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16003 TUSCOLA RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-1319
Mailing Address - Country:US
Mailing Address - Phone:760-242-8400
Mailing Address - Fax:760-242-8869
Practice Address - Street 1:16003 TUSCOLA RD
Practice Address - Street 2:SUITE F
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-1319
Practice Address - Country:US
Practice Address - Phone:760-242-8221
Practice Address - Fax:760-242-8859
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG55163208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
A52882Medicare UPIN