Healthcare Provider Details
I. General information
NPI: 1316109341
Provider Name (Legal Business Name): ROBIN QUAZI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/01/2008
Last Update Date: 08/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10833 LE CONTE AVE
LOS ANGELES CA
90095-0001
US
IV. Provider business mailing address
5767 W CENTURY BLVD SUITE 400
LOS ANGELES CA
90045-5631
US
V. Phone/Fax
- Phone: 310-267-8758
- Fax:
- Phone: 310-267-8758
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | A122945 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: