Azzam, Samir

Azzam, Samir is an individual health care provider with primary practice located at 1211 W La Palma Ave Ste 707 , Anaheim CA 92801-2814. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Azzam, Samir can be contacted via phone (714) 776-2100.

Contact Information

Primary practice address
1211 W La Palma Ave Ste 707 Anaheim CA 92801-2814
Phone: (714) 776-2100
Fax: (714) 776-1960
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X A51621 California
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A51621 California

Profile Details

NPI number 1891744538
LBN Legal business name Azzam, Samir
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2006
Last updated Jun 24th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891744538 NPPES
California MEDICAID 00A516210

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