Individual
SHAHDAD AZMOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10535 FOOTHILL BLVD, SUITE #365, RANCHO CUCAMONGA, CA 91730-3843
(909) 466-8810
(909) 466-8811
Mailing address
10535 FOOTHILL BLVD STE 365, RANCHO CUCAMONGA, CA 91730-7602
(909) 466-8810
(909) 466-8811
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A91785
CA
207RC0000X
Cardiovascular Disease Physician
A91785
CA
207RI0011X
Interventional Cardiology Physician
Primary
A91785
CA
Other
Enumeration date
10/18/2006
Last updated
12/01/2020
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