Provider Demographics
NPI:1083702815
Name:QURESHI, AZMATH SADRYDDIN (MD)
Entity Type:Individual
Prefix:MRS
First Name:AZMATH
Middle Name:SADRYDDIN
Last Name:QURESHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14350 WHITTIER BLVD
Mailing Address - Street 2:STE 230
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2147
Mailing Address - Country:US
Mailing Address - Phone:562-945-5625
Mailing Address - Fax:562-945-4868
Practice Address - Street 1:14350 WHITTIER BLVD
Practice Address - Street 2:STE 230
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2147
Practice Address - Country:US
Practice Address - Phone:562-945-5625
Practice Address - Fax:562-945-4868
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36039207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A360390Medicaid
B50308Medicare UPIN
B50308Medicare ID - Type Unspecified