Provider Demographics
NPI:1750989141
Name:NOOR SABA AZIMI MD INC
Entity type:Organization
Organization Name:NOOR SABA AZIMI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NOOR
Authorized Official - Middle Name:S
Authorized Official - Last Name:AZIMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-538-5500
Mailing Address - Street 1:PO BOX 347226
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33234-7226
Mailing Address - Country:US
Mailing Address - Phone:786-621-3900
Mailing Address - Fax:786-975-2608
Practice Address - Street 1:19845 LAKE CHABOT RD STE 200
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4055
Practice Address - Country:US
Practice Address - Phone:510-538-5500
Practice Address - Fax:510-538-5505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty