Provider Demographics
NPI:1467740621
Name:IRAJ AZIZI, M.D INC.
Entity Type:Organization
Organization Name:IRAJ AZIZI, M.D INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:IRAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-274-9500
Mailing Address - Street 1:9200 W PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-1319
Mailing Address - Country:US
Mailing Address - Phone:310-274-9500
Mailing Address - Fax:
Practice Address - Street 1:9200 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1319
Practice Address - Country:US
Practice Address - Phone:310-274-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43320207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty