Basic Information
| Provider Information | |||||||||
| NPI: | 1033552062 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OWAIS ZAIDI MEDICAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1042 N MOUNTAIN AVE | ||||||||
| Address2: | STE. B BOX 145 | ||||||||
| City: | UPLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917863695 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094500158 | ||||||||
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| Practice Location | |||||||||
| Address1: | 255 E BONITA AVE | ||||||||
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| City: | POMONA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917671923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094500158 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2013 | ||||||||
| LastUpdateDate: | 11/17/2016 | ||||||||
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| AuthorizedOfficialLastName: | ZAIDI | ||||||||
| AuthorizedOfficialFirstName: | OWAIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 9094500158 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | A102262 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.