Individual
AZAD MATARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11515 EL CAMINO REAL STE 100, SAN DIEGO, CA 92130-3034
(858) 279-1223
Mailing address
11515 EL CAMINO REAL STE 100, SAN DIEGO, CA 92130-3034
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A195018
CA
390200000X
Student in an Organized Health Care Education/Training Program
MT222086
PA
Other
Enumeration date
10/12/2020
Last updated
09/23/2024
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