Provider Demographics
NPI:1952547002
Name:AZER, FIBI LEON (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:FIBI
Middle Name:LEON
Last Name:AZER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 N ALTA AVE STE B
Mailing Address - Street 2:
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618-3250
Mailing Address - Country:US
Mailing Address - Phone:559-568-3151
Mailing Address - Fax:800-507-1641
Practice Address - Street 1:531 N ALTA AVE STE B
Practice Address - Street 2:
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618-3250
Practice Address - Country:US
Practice Address - Phone:559-568-3151
Practice Address - Fax:800-507-1641
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-01625363A00000X
CAPA56210363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2759474Medicare PIN