MEDICARE: IRAJ AZIZI, M.D INC.

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	A43320	CA

General Provider Information

NPI Number	:	1467740621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IRAJ AZIZI, M.D INC.

Provider Business Mailing Address
First Line	:	9200 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1319
Country	:	US
Telephone Number	:	310-274-9500
Fax Number	:

Provider Business Practice Location Address
First Line	:	9200 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1319
Country	:	US
Telephone Number	:	310-274-9500
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. IRAJ AZIZI
Credential	:	M.D.
Telephone Number	:	310-274-9500

Provider Enumeration Date	:	07/21/2011
Last Update Date	:	07/21/2011

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