JACK AZADM.D.INC. NPI 1891795613

NPI Information

JACK AZAD,M.D.,INC. is a general practice in Los Angeles, CA. JACK AZAD,M.D.,INC. NPI is 1891795613. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Tri-city Medical Group.

The provider's business location address is:

11900 AVALON BLVD STE 101
LOS ANGELES, CA
ZIP 90061-867
Phone: (323) 756-1317
Fax: (323) 756-4015

The provider's authorized official is Jack Azad .
The authorized official title is President and has the following contact phone number (323) 756-1317.

The CLIA number assigned to this NPI record is 05D2124069 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/22/2005 and was last updated on 6/15/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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