Organization
AZUSA WAY FAMILY MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HODA FARID (DIRCECTOR)
(626) 912-6670
Entity
Organization
Contact information
Practice address
561 S AZUSA WAY, LA PUENTE, CA 91744-5113
(626) 912-6670
Mailing address
561 S AZUSA WAY, LA PUENTE, CA 91744-5113
(626) 912-6670
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/22/2007
Last updated
10/22/2007
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