Healthcare Provider Details

I. General information

NPI: 1295596195
Provider Name (Legal Business Name): AZURE MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2024
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7172 MAGNOLIA AVE
RIVERSIDE CA
92504-3804
US

IV. Provider business mailing address

15453 TANNER RIDGE CIR
SAN DIEGO CA
92127-3675
US

V. Phone/Fax

Practice location:
  • Phone: 951-788-2224
  • Fax: 951-788-5190
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MEENAKSHI A NARASIMHAMURTHY
Title or Position: PRESIDENT
Credential: MD
Phone: 434-242-2145