MEDICARE: DR. ASIF M AZIMI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QB0002X	Obesity Medicine (Family Medicine) Physician	A89704	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225226012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASIF M AZIMI M.D.

Provider Business Mailing Address
First Line	:	16705 HAWTHORNE BLVD
Second Line	:
City	:	LAWNDALE
State	:	CA
Zip	:	90260-3244
Country	:	US
Telephone Number	:	310-370-2577
Fax Number	:

Provider Business Practice Location Address
First Line	:	16705 HAWTHORNE BLVD
Second Line	:
City	:	LAWNDALE
State	:	CA
Zip	:	90260-3244
Country	:	US
Telephone Number	:	310-370-2577
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2007
Last Update Date	:	10/05/2007

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