Healthcare Provider Details

I. General information

NPI: 1629021092
Provider Name (Legal Business Name): ELIZABETH ADAOBI AZINGE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2661 E WASHINGTON BLVD
PASADENA CA
91107-1412
US

IV. Provider business mailing address

2661 E WASHINGTON BLVD
PASADENA CA
91107-1412
US

V. Phone/Fax

Practice location:
  • Phone: 626-798-4952
  • Fax: 626-296-1403
Mailing address:
  • Phone: 626-798-4952
  • Fax: 626-798-4952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA855971
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: