Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 55691 | CT |
NPI | 1043598378 |
---|---|
Provider Name | Dr. Sidra Azim |
First Address | Los Altos, CA 94022-1408 |
Second Address | Mountain View, CA 94040-2833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2011 |
Last Update Date | 28/09/2020 |