Organization
CARLSBAD VILLAGE FAMILY PRACTICE MEDICAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHYAR AJIR DO (PRESIDENT)
(760) 729-4952
Entity
Organization
Contact information
Practice address
2801 JEFFERSON ST, CARLSBAD, CA 92008-1720
(760) 729-4952
(760) 729-2738
Mailing address
2801 JEFFERSON ST, CARLSBAD, CA 92008-1720
(760) 729-4952
(760) 729-2738
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
20A6683
CA
207Q00000X
Family Medicine Physician
Primary
20A6701
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0098810
—
CA
01
—
ZZZ09018Z
BLUE CROSS
—
Enumeration date
06/15/2006
Last updated
06/19/2014
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