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General NPI Number Information
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NPI Number | 1376726182
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Entity Type | Organization
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Legal Business Name | MICHAEL JAZAYERI, INC.
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Dates
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Enumeration Date | 12/14/2007
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Last Update Date | 12/14/2007
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Provider Practice Location Address
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Address Line | 2010 E 1ST ST SUITE 270
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City | SANTA ANA
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State | CA
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Zip | 92705-4006
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Country | US
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Telephone | 714-834-0101
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Fax |
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Provider Business Mailing Address
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Address Line | 3972 BARRANCA PKWY SUITE J-214
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City | IRVINE
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State | CA
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Zip | 92606-1204
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Country | US
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Telephone | 949-307-4185
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL A JAZAYERI
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Credential | M.D.
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Telephone | 949-307-4185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G73210
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License Number State | CA
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