Individual
EHSAN ZANDIFAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
515 HUGH AVE, SPARTA, MO 65753-1220
(417) 634-3000
Mailing address
1570 S 14TH AVE APT 13, OZARK, MO 65721-8940
(949) 466-4181
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2019016567
MO
Other
Enumeration date
04/15/2020
Last updated
04/15/2020
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