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General NPI Number Information
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NPI Number | 1043879026
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Entity Type | Individual
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Provider Name | EDGARDO OMAR PAZ NAH
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Gender | Male
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Dates
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Enumeration Date | 06/12/2019
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | 900 LAUREL AVE
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City | SAN MATEO
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State | CA
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Zip | 94401-4211
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Country | US
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Telephone | 650-293-9407
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Fax | 650-343-3024
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Provider Business Mailing Address
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Address Line | 2660 MUIRFIELD CIR
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City | SAN BRUNO
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State | CA
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Zip | 94066-1227
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Country | US
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Telephone | 415-525-1914
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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