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General NPI Number Information
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NPI Number | 1689550055
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Entity Type | Organization
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Legal Business Name | SOCAL ACADEMIC SURGICAL CONSULTANTS INC
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 400 N PEPPER AVE STE 308
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City | COLTON
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State | CA
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Zip | 92324-1801
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Country | US
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Telephone | 646-770-4660
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 123
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City | PASADENA
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State | CA
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Zip | 91102-0123
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMIR ALI RAHNEMAI AZAR
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Credential | MD
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Telephone | 646-770-4660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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