Provider Demographics
NPI:1033643424
Name:MALEKZADEH, POURAN (MD)
Entity type:Individual
Prefix:
First Name:POURAN
Middle Name:
Last Name:MALEKZADEH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E VALENCIA MESA DR
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3813
Mailing Address - Country:US
Mailing Address - Phone:714-992-5350
Mailing Address - Fax:
Practice Address - Street 1:100 E VALENCIA MESA DR STE 311
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3800
Practice Address - Country:US
Practice Address - Phone:714-992-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101271975207V00000X
CAA200509207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology