Provider Demographics
NPI:1396749941
Name:SYED F AZAM MEDICAL ASSOCIATES INC
Entity type:Organization
Organization Name:SYED F AZAM MEDICAL ASSOCIATES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FARZANA
Authorized Official - Middle Name:JABEEN
Authorized Official - Last Name:QURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-202-0686
Mailing Address - Street 1:35400 BOB HOPE DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1772
Mailing Address - Country:US
Mailing Address - Phone:760-202-0686
Mailing Address - Fax:760-770-4563
Practice Address - Street 1:35400 BOB HOPE DR
Practice Address - Street 2:SUITE 210
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1772
Practice Address - Country:US
Practice Address - Phone:760-202-0686
Practice Address - Fax:760-770-4563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ27288ZMedicare PIN