Healthcare Provider Details
I. General information
NPI: 1922768167
Provider Name (Legal Business Name): ASMA M KAZI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/29/2021
Last Update Date: 09/22/2022
Certification Date: 09/22/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
72757 FRED WARING DR STE 8
PALM DESERT CA
92260-9404
US
IV. Provider business mailing address
PO BOX 14144
PALM DESERT CA
92255-4144
US
V. Phone/Fax
- Phone: 760-895-2600
- Fax: 760-895-2601
- Phone: 760-898-6442
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ASMA
M
KAZI
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 760-898-6442