Provider Demographics
NPI:1932815198
Name:AZRA ASHRAF MD PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:AZRA ASHRAF MD PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NITA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-547-3346
Mailing Address - Street 1:360 SAN MIGUEL DR STE 207
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7820
Mailing Address - Country:US
Mailing Address - Phone:949-877-7910
Mailing Address - Fax:
Practice Address - Street 1:360 SAN MIGUEL DR STE 207
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7820
Practice Address - Country:US
Practice Address - Phone:949-877-7910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty