Basic Information
Provider Information
NPI: 1477936391
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AZIZ
FirstName: ZOHRA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: PA-C, MMS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1804 EMBARCADERO RD
Address2: SUITE 100
City: PALO ALTO
State: CA
PostalCode: 943033341
CountryCode: US
TelephoneNumber: 6507234000
FaxNumber: 6504985840
Practice Location
Address1: 300 PASTEUR DR
Address2:  
City: STANFORD
State: CA
PostalCode: 943052200
CountryCode: US
TelephoneNumber: 6507234000
FaxNumber: 6504985840
Other Information
ProviderEnumerationDate: 07/09/2015
LastUpdateDate: 12/11/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X52486CAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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