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General NPI Number Information
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NPI Number | 1679196836
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Entity Type | Individual
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Provider Name | IZZA BAZIGH M.D
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Gender | Female
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Dates
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Enumeration Date | 05/22/2020
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 4000 CIVIC CENTER DR STE 200A
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City | SAN RAFAEL
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State | CA
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Zip | 94903-5233
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Country | US
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Telephone | 415-464-0171
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Fax | 415-464-0171
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Provider Business Mailing Address
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Address Line | 13400 E SHEA BLVD
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-5499
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Country | US
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Telephone | 480-301-8000
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 70252
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License Number State | AZ
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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 | A206100
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License Number State | CA
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