NPI 1265459184 · live from the CMS NPI Registry
Azar S Bastanfar, Certified Nurse Prac
Nurse Practitioner in La Jolla, CA. National Provider Identifier 1265459184, active.
NPI record
| NPI | 1265459184 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner 363L00000X |
| Practice location | 9850 Genesee Ave, Suite 600, La Jolla, CA 92037 |
| Practice phone | 858-453-0753 |
| Mailing address | File #54433, Los Angeles, CA 90074 |
| Enumerated | July 16, 2006 |
| Last updated | August 15, 2011 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Obstetrics & Gynecology | 363LX0001X | 538431 (CA) |
| Nurse Practitioner primary | 363L00000X | 9526 (CA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.