Samir Azzam Md Inc | |
1211 W La Palma Ave Ste 707 Anaheim CA 92801-2814 | |
(714) 776-2100 | |
(714) 776-1960 |
Full Name | Samir Azzam Md Inc |
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Speciality | Family Medicine |
Location | 1211 W La Palma Ave Ste 707, Anaheim, California |
Authorized Official Name and Position | Samir Azzam (OWNER) |
Authorized Official Contact | 7147762100 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Samir Azzam Md Inc 1211 W La Palma Ave Ste 707 Anaheim CA 92801-2814 Ph: (714) 776-2100 | Samir Azzam Md Inc 1211 W La Palma Ave Ste 707 Anaheim CA 92801-2814 Ph: (714) 776-2100 |
NPI Number | 1437336435 |
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Provider Enumeration Date | 01/22/2008 |
Last Update Date | 06/20/2011 |
Medicare PECOS PAC ID | 8527141738 |
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Medicare Enrollment ID | O20080212000147 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437336435 | NPI | - | NPPES |
A51621 | Other | CA | LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | A51621 (California) | Primary |
Provider Name | Samir J Azzam |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1891744538 PECOS PAC ID: 6204800469 Enrollment ID: I20040823001590 |
The Family Medicine Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1211 W. La Palma Avenue, Suite #404, Anaheim, CA 92801 Phone: 714-772-1030 Fax: 714-772-1758 | |
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