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General NPI Number Information
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NPI Number | 1124154703
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Entity Type | Organization
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Legal Business Name | ANJUM B QAZI M D A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 2173 LOMITA BLVD STE 104
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City | LOMITA
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State | CA
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Zip | 90717-1636
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Country | US
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Telephone | 424-305-4169
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Fax | 310-791-7409
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Provider Business Mailing Address
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Address Line | 2173 LOMITA BLVD STE 104
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City | LOMITA
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State | CA
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Zip | 90717-1636
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Country | US
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Telephone | 424-305-4169
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Fax | 310-791-7409
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANJUM B QAZI
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Credential | MD
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Telephone | 310-750-5359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A88843
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License Number State | CA
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