Provider Demographics
NPI:1366760514
Name:JABAJI, ZIYAD BAHIJE (MD)
Entity type:Individual
Prefix:DR
First Name:ZIYAD
Middle Name:BAHIJE
Last Name:JABAJI
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 1:10833 LE CONTE AVE # 72-229
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-1749
Mailing Address - Country:US
Mailing Address - Phone:310-825-6643
Mailing Address - Fax:
Practice Address - Street 1:77 ROLLING OAKS DR
Practice Address - Street 2:STE 203
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1019
Practice Address - Country:US
Practice Address - Phone:805-379-9696
Practice Address - Fax:805-379-9695
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA114231208C00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery