Basic Information
| Provider Information | |||||||||
| NPI: | 1215225214 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AZAR | ||||||||
| FirstName: | SAMAN | ||||||||
| MiddleName: | HAMIDI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4001 9TH ST N | ||||||||
| Address2: | APT. 310 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 222031956 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1020 S ARROYO PKWY | ||||||||
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| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911053911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6264032794 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2011 | ||||||||
| LastUpdateDate: | 07/12/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.