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NPI Code Detail

MEDICARE: WLED WAZNI, M.D. MEDICAL CORPORATION

MEDICARE: WLED WAZNI, M.D. MEDICAL CORPORATION
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
1207T00000XNeurological Surgery Physician
22084V0102XVascular Neurology Physician

General Provider Information

NPI Number : 1134651573
Entity Type Code : Organization
Provider Name (Legal Business Name) : WLED WAZNI, M.D. MEDICAL CORPORATION
Provider Business Mailing Address
First Line : 478 S OAKLAND AVE
Second Line : UNIT 3
City : PASADENA
State : CA
Zip : 91101-4032
Country : US
Telephone Number : 586-303-5519
Fax Number :
Provider Business Practice Location Address
First Line : 1050 LINDEN AVE FL 2
Second Line :
City : LONG BEACH
State : CA
Zip : 90813-3321
Country : US
Telephone Number : 562-491-9270
Fax Number : 562-491-7985
Authorized Official
Title or Position : OWNER
Name : DR. WLED WAZNI
Credential : MD
Telephone Number : 586-303-5519
Provider Enumeration Date : 04/03/2017
Last Update Date : 02/05/2020

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