Healthcare Provider Details

I. General information

NPI: 1942506878
Provider Name (Legal Business Name): ISAAC BENJAMIN PAZ MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2011
Last Update Date: 02/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 S FAIR OAKS AVE SUITE 101
PASADENA CA
91105-2622
US

IV. Provider business mailing address

1044 S FAIR OAKS AVE SUITE 101
PASADENA CA
91105-2622
US

V. Phone/Fax

Practice location:
  • Phone: 626-768-4415
  • Fax: 626-403-0311
Mailing address:
  • Phone: 626-768-4415
  • Fax: 626-403-0311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberA48296
License Number StateCA

VIII. Authorized Official

Name: I. BENJAMIN PAZ
Title or Position: PRESIDENT
Credential: MD
Phone: 626-353-5549