Individual
DR. ALI AZARM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4841 KNIGHTSWOOD WAY, GRANITE BAY, CA 95746-6456
(718) 986-2316
Mailing address
4841 KNIGHTSWOOD WAY, GRANITE BAY, CA 95746-6456
(718) 986-2316
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
002589
NY
207RG0100X
Gastroenterology Physician
Primary
A88485
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A88485
MEDICAL LICENSE
CA
Enumeration date
07/05/2006
Last updated
01/14/2022
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