Provider Demographics
NPI:1619396769
Name:RAZZAKI, TANZILA SHAKIR (MD)
Entity Type:Individual
Prefix:
First Name:TANZILA
Middle Name:SHAKIR
Last Name:RAZZAKI
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 1:500 SUPERIOR AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3660
Mailing Address - Country:US
Mailing Address - Phone:971-295-9797
Mailing Address - Fax:
Practice Address - Street 1:500 SUPERIOR AVE STE 100
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3660
Practice Address - Country:US
Practice Address - Phone:971-295-9797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA183041207RE0101X
NY310875-01207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism