Active NPI
Randa R Zaky
- Driver
- Costa Mesa, CA
National Provider Identifier
1033963616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- Practice address
- 2900 Bristol Street
Buidling H Suite 101
Costa Mesa, CA 92626 - Phone
- (949) 777-6516
- Fax
- (949) 777-6479
- NPI assigned
- Apr 11, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Primary |
Addresses
Primary practice location
2900 Bristol Street
Buidling H Suite 101
Costa Mesa, CA 92626
Mailing address
2900 Bristol Street
Buidling H Suite 101
Costa Mesa, CA 92626
Phone (949) 777-6516
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 12925 Hesperia Victorville, Inc. | Current | Accepting new patients |
Locations
2900 Bristol St
Ste H101
Costa Mesa, CA 92626
Phone (949) 426-0093
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713139200000",
"number": "1033963616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 BRISTOL STREET",
"address_2": "BUIDLING H SUITE 101",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "92626",
"telephone_number": "949-777-6516",
"fax_number": "949-777-6479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 BRISTOL STREET",
"address_2": "BUIDLING H SUITE 101",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "92626",
"telephone_number": "949-777-6516",
"fax_number": "949-777-6479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZAKY",
"first_name": "RANDA",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-11",
"last_updated": "2024-04-15",
"certification_date": "2024-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.