Provider Demographics
NPI:1538180492
Name:QAZI, ANJUM B (MD)
Entity type:Individual
Prefix:
First Name:ANJUM
Middle Name:B
Last Name:QAZI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2173 LOMITA BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-1636
Mailing Address - Country:US
Mailing Address - Phone:424-305-4169
Mailing Address - Fax:310-791-7409
Practice Address - Street 1:2173 LOMITA BLVD STE 104
Practice Address - Street 2:
Practice Address - City:LOMITA
Practice Address - State:CA
Practice Address - Zip Code:90717-1636
Practice Address - Country:US
Practice Address - Phone:424-305-4169
Practice Address - Fax:310-791-7409
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2023-09-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA88843207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI49017Medicare UPIN