Provider Demographics
NPI:1205381647
Name:AZMATH S. QURESHI M.D. INC
Entity Type:Organization
Organization Name:AZMATH S. QURESHI M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AZMATH
Authorized Official - Middle Name:S
Authorized Official - Last Name:QURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-945-5625
Mailing Address - Street 1:14350 WHITTIER BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2138
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:SUITE 230
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2138
Practice Address - Country:US
Practice Address - Phone:562-945-5625
Practice Address - Fax:562-945-4868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB50308Medicare UPIN