Gholizadeh, Maryam
Gholizadeh, Maryam is an individual health care provider with primary practice located at 1120 W La Veta Ave Ste. 100, Orange CA 92868-4231. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Surgery, which is considered as her primary health care specialty. Gholizadeh, Maryam can be contacted via phone (714) 289-4704.Contact Information
Primary practice address
1120 W La Veta Ave Ste. 100
Orange CA 92868-4231
Phone: (714) 289-4704
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Surgery | 2086S0120X | A83935 | California |
Profile Details
| NPI number | 1194724583 |
|---|---|
| LBN Legal business name | Gholizadeh, Maryam |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194724583 | NPPES |
| California | MEDICAID | 00A839350 |
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