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Organization
CARLSBAD VILLAGE FAMILY PRACTICE MEDICAL ASSOCIATES INC
Active
Organization
CARLSBAD VILLAGE FAMILY PRACTICE MEDICAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHYAR AJIR DO (PRESIDENT)
(760) 729-4952
Entity
Organization
Contact information
Practice address
2801 JEFFERSON ST, CARLSBAD, CA 92008-1720
(760) 729-4952
(760) 729-2738
Mailing address
2801 JEFFERSON ST, CARLSBAD, CA 92008-1720
(760) 729-4952
(760) 729-2738
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
20A6683
CA
207Q00000X
Family Medicine Physician
Primary
20A6701
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0098810
—
CA
01
—
ZZZ09018Z
BLUE CROSS
—
Enumeration date
06/15/2006
Last updated
06/19/2014
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