MEDICARE: LEILA AZAD 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
1	1223G0001X	General Practice Dentistry	53990	CA

General Provider Information

NPI Number	:	1225067150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEILA AZAD DDS

Provider Business Mailing Address
First Line	:	180 MONTGOMERY ST STE 2440
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94104-4258
Country	:	US
Telephone Number	:	415-398-4110
Fax Number	:	415-398-4195

Provider Business Practice Location Address
First Line	:	180 MONTGOMERY ST STE 2440
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94104-4258
Country	:	US
Telephone Number	:	415-398-4110
Fax Number	:	415-398-4195

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	06/01/2023

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