Basic Information
| Provider Information | |||||||||
| NPI: | 1346612116 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZAMANIAN | ||||||||
| FirstName: | ROYA | ||||||||
| MiddleName: | SAFARI | ||||||||
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| Credential: | APRN,FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5395 RUFFIN RD STE 204 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921231338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585713630 | ||||||||
| FaxNumber: | 8582953948 | ||||||||
| Practice Location | |||||||||
| Address1: | 5395 RUFFIN RD STE 204 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921231338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585713630 | ||||||||
| FaxNumber: | 8582953948 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2015 | ||||||||
| LastUpdateDate: | 04/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 95011956 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.