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Individual

MR. MANSOOR AZIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3770 KEYSTONE AVE APT 107, LOS ANGELES, CA 90034-6340
(951) 961-8639
Mailing address
3770 KEYSTONE AVE APT 107, LOS ANGELES, CA 90034-6340
(951) 961-8639

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A128143
CA
207RN0300X
Nephrology Physician
Primary
A128143
CA

Other

Enumeration date
04/19/2012
Last updated
02/07/2018
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