| Azam Md Pc | |
| 
					3455 Ingraham St San Diego CA 92109-6713  | |
| (619) 937-2055 | |
| Not Available | 
| Full Name | Azam Md Pc | 
|---|---|
| Speciality | Clinic/center - Multi-specialty | 
| Location | 3455 Ingraham St, San Diego, California | 
| Authorized Official Name and Position | Arsalan Azam (CEO/CMO) | 
| Authorized Official Contact | 2165262099 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Azam Md Pc 4860 Muir Ave San Diego CA 92107-2102 Ph: (216) 526-2099  | Azam Md Pc 3455 Ingraham St San Diego CA 92109-6713 Ph: (619) 937-2055  | 
| NPI Number | 1437864014 | 
|---|---|
| Provider Enumeration Date | 01/18/2023 | 
| Last Update Date | 11/16/2023 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1437864014 | NPI | - | NPPES | 
| 161461 | Other | CA | MEDICAL BOARD OF CALIFORNIA | 
| 50842 | Other | CA | BOARD OF BEHAVIORAL SCIENCE | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary | 
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Aldiwani Medical Group Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11409 Windy Summit Pl, San Diego, CA 92127 Phone: 832-371-3279 Fax: 619-939-4556  | |
Azam Md & Mcjunkin Prof Corp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3455 Ingraham St, San Diego, CA 92109 Phone: 619-937-2055  | |
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