Provider Demographics
NPI:1265589329
Name:AZIMI, SHERRI S (OD)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:S
Last Name:AZIMI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2423
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-1723
Mailing Address - Country:US
Mailing Address - Phone:858-344-5430
Mailing Address - Fax:760-436-1230
Practice Address - Street 1:27972 CABOT RD
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1211
Practice Address - Country:US
Practice Address - Phone:949-347-1919
Practice Address - Fax:949-347-8871
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10574152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist