Provider Demographics
NPI:1477802148
Name:HADIAN JAZI, RAZIEH (MD)
Entity Type:Individual
Prefix:
First Name:RAZIEH
Middle Name:
Last Name:HADIAN JAZI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14150 CULVER DRIVE, STE. 100
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604
Mailing Address - Country:US
Mailing Address - Phone:949-552-4584
Mailing Address - Fax:949-551-5612
Practice Address - Street 1:14150 CULVER DRIVE, STE. 100
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604
Practice Address - Country:US
Practice Address - Phone:949-552-4584
Practice Address - Fax:949-551-5612
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC162616207Q00000X
WI63080-02207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine