Provider Demographics
NPI:1669520490
Name:GHIASI, ZAHRA (MD)
Entity type:Individual
Prefix:DR
First Name:ZAHRA
Middle Name:
Last Name:GHIASI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 WATERWORKS WAY STE 245
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3175
Mailing Address - Country:US
Mailing Address - Phone:949-777-5970
Mailing Address - Fax:
Practice Address - Street 1:113 WATERWORKS WAY STE 245
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3175
Practice Address - Country:US
Practice Address - Phone:949-777-5970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78525207WX0009X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1518142462OtherORGANIZATION NPI
CA1518142462OtherORGANIZATION NPI