Provider Demographics
NPI:1669490660
Name:AZIZ, ALI DARIUS (MD)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:DARIUS
Last Name:AZIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5225 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4301
Mailing Address - Country:US
Mailing Address - Phone:323-993-7515
Mailing Address - Fax:323-934-4008
Practice Address - Street 1:5225 WILSHIRE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4301
Practice Address - Country:US
Practice Address - Phone:323-993-7515
Practice Address - Fax:323-934-4008
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAO457992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA45799Medicare PIN