MEDICARE: NARCISO M AZURIN MD 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	213E00000X	Podiatrist
2	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

General Provider Information

NPI Number	:	1659479269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NARCISO M AZURIN MD INC

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	:	PRESIDENT PHYSICIAN
Name	:	NARCISO M AZURIN
Credential	:	MD
Telephone Number	:	323-566-4111

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	03/15/2010

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