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NPI Code Detail

MEDICARE: AZAR DANESHBOD MD MEDICAL CORPORATION

MEDICARE: AZAR DANESHBOD MD MEDICAL CORPORATION
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
1207ZC0500XCytopathology Physician
2207ZP0102XAnatomic Pathology & Clinical Pathology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669433959
Entity Type Code : Organization
Provider Name (Legal Business Name) : AZAR DANESHBOD MD MEDICAL CORPORATION
Provider Business Mailing Address
First Line : PO BOX 10076
Second Line :
City : VAN NUYS
State : CA
Zip : 91410-0076
Country : US
Telephone Number : 805-578-8300
Fax Number : 805-578-8950
Provider Business Practice Location Address
First Line : 21530 PIONEER BLVD
Second Line :
City : HAWAIIAN GARDENS
State : CA
Zip : 90716-2608
Country : US
Telephone Number : 562-799-3132
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : AZAR DANESHBOD
Credential : MD
Telephone Number : 562-799-3132
Provider Enumeration Date : 03/28/2006
Last Update Date : 06/25/2008

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