MEDICARE: NARCISO AZURIN 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	207Q00000X	Family Medicine Physician	A36302	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
2	A36302	OTHER	CA	LICENSE NUMBER

General Provider Information

NPI Number	:	1326132945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NARCISO AZURIN M.D.

Provider Business Mailing Address
First Line	:	4075 TWEEDY BLVD
Second Line	:
City	:	SOUTH GATE
State	:	CA
Zip	:	90280-6146
Country	:	US
Telephone Number	:	323-566-4111
Fax Number	:	323-563-0439

Provider Business Practice Location Address
First Line	:	4075 TWEEDY BLVD
Second Line	:
City	:	SOUTH GATE
State	:	CA
Zip	:	90280-6146
Country	:	US
Telephone Number	:	323-566-4111
Fax Number	:	323-563-0439

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	02/21/2012

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