Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 33061 | CA |
NPI | 1053439018 |
---|---|
Provider Name | Dr. Ann Azama |
First Address | San Francisco, CA 94132-1630 |
Second Address | San Francisco, CA 94132-1630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 08/07/2007 |