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General NPI Number Information
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NPI Number | 1629662945
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Entity Type | Organization
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Legal Business Name | AZAR FOOT & ANKLE SPECIALIST
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Dates
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Enumeration Date | 02/26/2021
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Last Update Date | 05/25/2025
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Provider Practice Location Address
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Address Line | 13925 INDIAN ST
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City | MORENO VALLEY
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State | CA
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Zip | 92553-5718
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Country | US
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Telephone | 213-537-2927
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Fax |
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Provider Business Mailing Address
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Address Line | 9675 MONTE VISTA AVE STE D
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City | MONTCLAIR
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State | CA
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Zip | 91763-2213
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Country | US
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Telephone | 213-537-2927
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EDWARD SHIBLI AZAR
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Credential | DPM
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Telephone | 213-537-2927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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