Organization
AZAR DANESHBOD MD MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AZAR DANESHBOD MD (PRESIDENT)
(562) 799-3132
Entity
Organization
Contact information
Practice address
21530 PIONEER BLVD, HAWAIIAN GARDENS, CA 90716-2608
(562) 799-3132
Mailing address
PO BOX 10076, VAN NUYS, CA 91410-0076
(805) 578-8300
(805) 578-8950
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0093920
—
CA
Enumeration date
03/28/2006
Last updated
06/25/2008
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