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General NPI Number Information
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NPI Number | 1710133954
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Entity Type | Organization
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Legal Business Name | BABAK AZIZZADEH, INC.
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Dates
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Enumeration Date | 08/07/2008
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Last Update Date | 08/07/2008
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Provider Practice Location Address
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Address Line | 8670 WILSHIRE BLVD SUITE 200
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2924
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Country | US
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Telephone | 310-657-2006
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Fax |
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Provider Business Mailing Address
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Address Line | 8670 WILSHIRE BLVD SUITE 200
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2924
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Country | US
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Telephone | 310-657-2006
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. BABAK AZIZZADEH
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Credential | MD
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Telephone | 310-657-2006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | A64794
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License Number State | CA
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