Provider Demographics
NPI:1932725264
Name:YAZDIAN, AARON LEO (MD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:LEO
Last Name:YAZDIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 SOUTH ST APT A
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1841
Mailing Address - Country:US
Mailing Address - Phone:615-473-2457
Mailing Address - Fax:
Practice Address - Street 1:1335 SOUTH ST APT A
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-1841
Practice Address - Country:US
Practice Address - Phone:615-473-2457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT220275207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine