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NPI Code Detail

MEDICARE: DR. FAY M. AZAD MD

MEDICARE: DR. FAY M. AZAD MD
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
12084P0800XPsychiatry PhysicianA41441CA

General Provider Information

NPI Number : 1376647313
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FAY M. AZAD MD
Provider Business Mailing Address
First Line : 12636 HIGH BLUFF DR STE 400
Second Line :
City : SAN DIEGO
State : CA
Zip : 92130-2071
Country : US
Telephone Number : 818-889-8555
Fax Number : --
Provider Business Practice Location Address
First Line : 12636 HIGH BLUFF DR STE 400
Second Line :
City : SAN DIEGO
State : CA
Zip : 92130-2071
Country : US
Telephone Number : 818-889-8555
Fax Number : --
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2006
Last Update Date : 12/15/2022

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