Organization
KOUROS AZAR, MD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KOUROS AZAR MD (OWNER)
(805) 373-7073
Entity
Organization
Contact information
Practice address
425 HAALAND DR, SUITE 200, THOUSAND OAKS, CA 91361-5229
(805) 373-7073
(805) 373-1116
Mailing address
425 HAALAND DR, SUITE 200, THOUSAND OAKS, CA 91361-5229
(805) 373-7073
(805) 373-1116
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A79029
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508935040
INDIVIDUAL NPI
CA
Enumeration date
05/17/2010
Last updated
10/16/2020
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