Provider Demographics
NPI:1811932940
Name:ZADEH, TOURAN M (MD)
Entity type:Individual
Prefix:
First Name:TOURAN
Middle Name:M
Last Name:ZADEH
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 1:211 SOUTH MAIN STREET
Mailing Address - Street 2:STE E
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868
Mailing Address - Country:US
Mailing Address - Phone:714-288-3500
Mailing Address - Fax:714-288-3510
Practice Address - Street 1:211 SOUTH MAIN STREET
Practice Address - Street 2:STE E
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868
Practice Address - Country:US
Practice Address - Phone:714-288-3500
Practice Address - Fax:714-288-3510
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32610207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A326103Medicaid
W13778Medicare UPIN