Provider Demographics
NPI:1942506878
Name:ISAAC BENJAMIN PAZ MD INC
Entity Type:Organization
Organization Name:ISAAC BENJAMIN PAZ MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:I.
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:PAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-353-5549
Mailing Address - Street 1:1044 S FAIR OAKS AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2622
Mailing Address - Country:US
Mailing Address - Phone:626-768-4415
Mailing Address - Fax:626-403-0311
Practice Address - Street 1:1044 S FAIR OAKS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2622
Practice Address - Country:US
Practice Address - Phone:626-768-4415
Practice Address - Fax:626-403-0311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA482962086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA48296OtherCALIFORNIA MEDICARE