Provider Demographics
NPI:1063779163
Name:ZAHEDI, MARCO M (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:MARCO
Middle Name:M
Last Name:ZAHEDI
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3972 BARRANCA PKWY STE J
Mailing Address - Street 2:UNIT 490
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-8291
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 N TUSTIN AVE STE 120
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-6502
Practice Address - Country:US
Practice Address - Phone:949-371-9862
Practice Address - Fax:866-439-4879
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA138224208D00000X, 207QA0401X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine