MEDICARE: PHILIP AZER, M.D., A PROFESSIONAL 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
1	207Y00000X	Otolaryngology Physician	G13273	CA

General Provider Information

NPI Number	:	1902244890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHILIP AZER, M.D., A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	3660 CLAIREMONT DR
Second Line	:	SUITE 2
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-5909
Country	:	US
Telephone Number	:	858-270-8151
Fax Number	:	858-270-8121

Provider Business Practice Location Address
First Line	:	3660 CLAIREMONT DR
Second Line	:	SUITE 2
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-5909
Country	:	US
Telephone Number	:	858-270-8151
Fax Number	:	858-270-8121

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PHILIP AZER
Credential	:	M.D.
Telephone Number	:	858-270-8151

Provider Enumeration Date	:	06/13/2013
Last Update Date	:	06/13/2013

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