Individual
AZIN KHAZAELI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4445 EASTGATE MALL FL 2, SAN DIEGO, CA 92121-1979
(619) 436-4691
(415) 484-1944
Mailing address
10531 4SCOMMONS DR 166 541, SAN DIEGO, CA 92127
(203) 507-3870
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A154274
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2015
Last updated
10/07/2019
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