Provider Demographics
NPI:1962706556
Name:ZAHID, MUSTAFA (ABOC)
Entity type:Individual
Prefix:MR
First Name:MUSTAFA
Middle Name:
Last Name:ZAHID
Suffix:
Gender:M
Credentials:ABOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2363 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1613
Mailing Address - Country:US
Mailing Address - Phone:650-474-2020
Mailing Address - Fax:650-474-3600
Practice Address - Street 1:2363 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1613
Practice Address - Country:US
Practice Address - Phone:650-474-2020
Practice Address - Fax:650-474-3600
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-22
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD7555156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician