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General NPI Number Information
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NPI Number | 1780227694
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Entity Type | Organization
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Legal Business Name | NASSIR A AZIMI, MD, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/23/2019
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Last Update Date | 07/16/2020
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Provider Practice Location Address
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Address Line | 5565 GROSSMONT CENTER DR BLDG 3, SUITE 444
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City | LA MESA
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State | CA
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Zip | 91942-3020
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Country | US
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Telephone | 619-567-7400
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Fax | 888-714-0424
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Provider Business Mailing Address
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Address Line | 3755 AVOCADO BLVD # 239
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City | LA MESA
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State | CA
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Zip | 91941-7301
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Country | US
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Telephone | 619-462-9353
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Fax | 619-462-6038
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DARLA GRAHAM
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Credential |
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Telephone | 858-204-2104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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