Active NPI
Mariam Azimi, PT, DPT
- Physical Therapist
- San Diego, CA
National Provider Identifier
1306245121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1245587
- Practice address
- 9540 Towne Centre Dr
Suite 150
San Diego, CA 92121-1988 - Phone
- (800) 585-1299
- NPI assigned
- Aug 18, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1245587 | TX | Primary |
| Physical Therapist | 225100000X | 12683 | CO |
Addresses
Primary practice location
9540 Towne Centre Dr
Suite 150
San Diego, CA 92121-1988
Mailing address
508 Grant St
Fort Morgan, CO 80701-3342
Phone (970) 380-8582
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12683 | CO | MD | Physical Therapist |
| 1245587 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408320000000",
"number": "1306245121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 GRANT ST",
"city": "FORT MORGAN",
"state": "CO",
"postal_code": "807013342",
"telephone_number": "970-380-8582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9540 TOWNE CENTRE DR",
"address_2": "SUITE 150",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921211988",
"telephone_number": "800-585-1299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZIMI",
"first_name": "MARIAM",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-18",
"last_updated": "2014-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1245587",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "12683",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.