| Azhar Muttalib Md A Professional Corporation | |
|
23639 Hawthorne Blvd Suite 102 Torrance CA 90505-5930 | |
| (310) 373-9980 | |
| (310) 373-5556 |
| Full Name | Azhar Muttalib Md A Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 23639 Hawthorne Blvd, Torrance, California |
| Authorized Official Name and Position | Azhar Muttalib (DOCTOR) |
| Authorized Official Contact | 3103739980 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Azhar Muttalib Md A Professional Corporation 23639 Hawthorne Blvd Suite 102 Torrance CA 90505-5930 Ph: (310) 373-9980 | Azhar Muttalib Md A Professional Corporation 23639 Hawthorne Blvd Suite 102 Torrance CA 90505-5930 Ph: (310) 373-9980 |
| NPI Number | 1619011392 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 09/04/2015 |
| Medicare PECOS PAC ID | 8022326693 |
|---|---|
| Medicare Enrollment ID | O20150930002926 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619011392 | NPI | - | NPPES |
| 2591934 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Azhar Muttalib |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124054721 PECOS PAC ID: 1759372410 Enrollment ID: I20040520001365 |
| Provider Name | Rehan Muttalib |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679068506 PECOS PAC ID: 8022353705 Enrollment ID: I20210914001227 |
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