| Morris Azad Dds Inc. | |
|
1104 San Fernando Rd San Fernando CA 91340-3210 | |
| (818) 361-6900 | |
| (818) 837-8569 |
| Full Name | Morris Azad Dds Inc. |
|---|---|
| Speciality | Dentist |
| Location | 1104 San Fernando Rd, San Fernando, California |
| Authorized Official Name and Position | Morris Azad (PRESIDENT) |
| Authorized Official Contact | 8183616900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Morris Azad Dds Inc. 1104 San Fernando Rd San Fernando CA 91340-3210 Ph: (818) 361-6900 | Morris Azad Dds Inc. 1104 San Fernando Rd San Fernando CA 91340-3210 Ph: (818) 361-6900 |
| NPI Number | 1811192701 |
|---|---|
| Provider Enumeration Date | 06/19/2007 |
| Last Update Date | 03/19/2012 |
| Medicare PECOS PAC ID | 2769723303 |
|---|---|
| Medicare Enrollment ID | O20190409002692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811192701 | NPI | - | NPPES |
| B39932-01 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 39932 (California) | Primary |
| Provider Name | Morris Azad |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1992886279 PECOS PAC ID: 2860797370 Enrollment ID: I20190409002656 |
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