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General NPI Number Information
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NPI Number | 1942534839
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Entity Type | Organization
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Legal Business Name | PRENATAL CLINIC JONATHN AZIZZADEH, MD INC
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Dates
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Enumeration Date | 09/24/2009
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Last Update Date | 09/24/2009
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Provider Practice Location Address
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Address Line | 4226 W BEVERLY BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90004
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Country | US
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Telephone | 213-384-4444
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Fax | 213-249-9300
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Provider Business Mailing Address
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Address Line | 1300 N VERMONT AVE 1ST FLOOR
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City | LOS ANGELES
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State | CA
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Zip | 90027-6005
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Country | US
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Telephone | 323-906-0000
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Fax | 323-953-6300
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. JONATHAN AZIZZADEH
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Credential | MD
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Telephone | 323-906-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A52711
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License Number State | CA
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