Provider Demographics
NPI:1043879026
Name:PAZ NAH, EDGARDO OMAR
Entity Type:Individual
Prefix:
First Name:EDGARDO
Middle Name:OMAR
Last Name:PAZ NAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 MUIRFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-1227
Mailing Address - Country:US
Mailing Address - Phone:415-525-1914
Mailing Address - Fax:
Practice Address - Street 1:900 LAUREL AVE
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-4211
Practice Address - Country:US
Practice Address - Phone:650-293-9407
Practice Address - Fax:650-343-3024
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)