Provider Demographics
NPI:1245345941
Name:NIAZI, ZAHID BIN MASUD (MD)
Entity type:Individual
Prefix:
First Name:ZAHID
Middle Name:BIN MASUD
Last Name:NIAZI
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 1:9401 E STOCKTON BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-5049
Mailing Address - Country:US
Mailing Address - Phone:916-525-3966
Mailing Address - Fax:916-525-3975
Practice Address - Street 1:9401 E STOCKTON BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-5049
Practice Address - Country:US
Practice Address - Phone:916-525-3966
Practice Address - Fax:916-525-3975
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC51628174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG30541Medicare UPIN
CA00C516280Medicare ID - Type UnspecifiedMEDICARE