Healthcare Provider Details

I. General information

NPI: 1679078109
Provider Name (Legal Business Name): JOSEPH S AZZAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 STANYAN ST
SAN FRANCISCO CA
94117-1019
US

IV. Provider business mailing address

505 PARNASSUS AVE
SAN FRANCISCO CA
94143-2204
US

V. Phone/Fax

Practice location:
  • Phone: 415-750-5942
  • Fax:
Mailing address:
  • Phone: 415-750-5942
  • Fax: 415-750-5594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA173245
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: