Provider Demographics
NPI:1144299173
Name:AAZAMI, HESSAM (MD)
Entity type:Individual
Prefix:MR
First Name:HESSAM
Middle Name:
Last Name:AAZAMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22030 SHERMAN WAY
Mailing Address - Street 2:SUITE #101
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1844
Mailing Address - Country:US
Mailing Address - Phone:818-312-9101
Mailing Address - Fax:818-312-9100
Practice Address - Street 1:22030 SHERMAN WAY
Practice Address - Street 2:SUITE #101
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1844
Practice Address - Country:US
Practice Address - Phone:818-312-9101
Practice Address - Fax:818-312-9100
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA85704208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI01714Medicare UPIN