Azad, Jack
Azad, Jack is an individual health care provider with primary practice located at 11900 Avalon Blvd #100, Los Angeles CA 90061-2867. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Azad, Jack can be contacted via phone (323) 756-1317.Contact Information
Primary practice address
11900 Avalon Blvd #100
Los Angeles CA 90061-2867
Phone: (323) 756-1317
Fax: (323) 756-4015
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | A54433 | California |
Profile Details
| NPI number | 1841489440 |
|---|---|
| LBN Legal business name | Azad, Jack |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 18th, 2007 |
| Last updated | Jun 15th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841489440 | NPPES |
| California | Other | 1891795613 | GROUP/CORPORATION NPI # |
| California | MEDICAID | 0A544334 | GROUP/CORPORATION NPI # |
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