Provider Demographics
NPI:1750348090
Name:AHMED, ZULFIQAR (MD)
Entity type:Individual
Prefix:
First Name:ZULFIQAR
Middle Name:
Last Name:AHMED
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 1:1030 S GLENDALE AVE
Mailing Address - Street 2:#406
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-5612
Mailing Address - Country:US
Mailing Address - Phone:818-244-7771
Mailing Address - Fax:818-244-7778
Practice Address - Street 1:1030 S GLENDALE AVE
Practice Address - Street 2:#406
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-5612
Practice Address - Country:US
Practice Address - Phone:818-244-7771
Practice Address - Fax:818-244-7778
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53666207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
W15179Medicare ID - Type Unspecified
G99755Medicare UPIN