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NPI Code Detail

MEDICARE: DR. TALA AZIZ DDS

MEDICARE: DR. TALA AZIZ DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist49274CA

General Provider Information

NPI Number : 1073727533
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TALA AZIZ DDS
Provider Business Mailing Address
First Line : P.O. BOX 22210
Second Line :
City : OAKLAND
State : CA
Zip : 94623-2210
Country : US
Telephone Number : 510-535-4000
Fax Number : 510-535-4128
Provider Business Practice Location Address
First Line : 3451 E. 12TH ST.
Second Line : 1ST FLOOR
City : OAKLAND
State : CA
Zip : 94601-3425
Country : US
Telephone Number : 510-535-3425
Fax Number : 510-536-9453
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 02/08/2012

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