Individual
SASAN FAZELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 DUARTE RD, DUARTE, CA 91010-3012
(626) 256-4673
(626) 408-3911
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD045237
DC
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
A168030
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2014
Last updated
12/10/2020
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