Basic Information
| Provider Information | |||||||||
| NPI: | 1942698840 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ATIF ALAZIZ M.D. INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18370 BURBANK BLVD | ||||||||
| Address2: | #201 | ||||||||
| City: | TARZANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913562804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8184622195 | ||||||||
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| Practice Location | |||||||||
| Address1: | 18370 BURBANK BLVD | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | TARZANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913562804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8184622195 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/30/2014 | ||||||||
| LastUpdateDate: | 12/30/2014 | ||||||||
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| AuthorizedOfficialLastName: | ALAZIZ | ||||||||
| AuthorizedOfficialFirstName: | ATIF | ||||||||
| AuthorizedOfficialMiddleName: | JAMEEL | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 8187262223 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | A26478 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.