Provider Demographics
NPI:1063033298
Name:NAZARY, AREZOU (MD)
Entity Type:Individual
Prefix:
First Name:AREZOU
Middle Name:
Last Name:NAZARY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AREZOU
Other - Middle Name:
Other - Last Name:NAZARY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:120 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-7834
Mailing Address - Country:US
Mailing Address - Phone:203-743-0100
Mailing Address - Fax:
Practice Address - Street 1:16300 SAND CANYON AVE STE 311
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3703
Practice Address - Country:US
Practice Address - Phone:949-791-3101
Practice Address - Fax:949-791-3112
Is Sole Proprietor?:No
Enumeration Date:2020-04-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA184368207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program