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General NPI Number Information
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NPI Number | 1316234693
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Entity Type | Individual
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Provider Name | NAYEF MOHAMMED A. KAZZAZ M.D
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Gender | Male
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Dates
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Enumeration Date | 07/07/2011
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Last Update Date | 02/11/2021
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Provider Practice Location Address
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Address Line | 6180 BROCKTON AVE STE 204
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City | RIVERSIDE
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State | CA
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Zip | 92506-2233
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Country | US
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Telephone | 951-781-7700
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Fax | 951-781-0313
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Provider Business Mailing Address
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Address Line | 6180 BROCKTON AVE STE 204
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City | RIVERSIDE
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State | CA
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Zip | 92506-2233
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Country | US
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Telephone | 951-781-7700
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Fax | 951-781-0313
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 51325
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 51325
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License Number State | KY
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