Individual
DR. AZAM SHAMANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5555 RESERVOIR DR, STE 312, SAN DIEGO, CA 92120-5134
(619) 639-7285
(619) 639-7286
Mailing address
5555 RESERVOIR DR, STE 312, SAN DIEGO, CA 92120-5134
(619) 639-7285
(619) 639-7286
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A109713
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A109713
LICENSE NUMBER
CA
Enumeration date
08/03/2009
Last updated
06/16/2015
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