MEDICARE: DR. AFSANEH BARZI 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	207R00000X	Internal Medicine Physician	M2256	TX
2	207RH0000X	Hematology (Internal Medicine) Physician	A117268	CA
3	207RX0202X	Medical Oncology Physician	A117268	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	W18762	OTHER	CA	GROUP MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	GR0100430	OTHER	CA	GROUP MEDICAL
3	1902846306	OTHER	CA	GROUP NPI

General Provider Information

NPI Number	:	1265480412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AFSANEH BARZI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 31309
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90031-0309
Country	:	US
Telephone Number	:	323-865-3105
Fax Number	:	323-865-0061

Provider Business Practice Location Address
First Line	:	1441 EASTLAKE AVE
Second Line	:	NOR 8302E
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-0000
Country	:	US
Telephone Number	:	323-865-3105
Fax Number	:	323-865-0061

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	11/12/2020

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Directions to “ DR. AFSANEH BARZI M.D.” Practice Location

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