Individual
MICHAEL P. AZEVEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1805 E FIR AVE, SUITE 102, FRESNO, CA 93720-3859
(559) 325-3070
(559) 325-3073
Mailing address
1805 E FIR AVE, SUITE 102, FRESNO, CA 93720-3859
(559) 325-3070
(559) 325-3073
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A66383
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A663830
BLUE SHIELD
—
05
—
00A663830
—
CA
01
—
320024715
BLUE CROSS
—
01
—
348538500
US DEPT OF LABOR
—
Enumeration date
01/24/2006
Last updated
12/15/2021
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