Azin Khazaeli, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A154274 Issued in CA

Practice address

4445 Eastgate Mall FL 2
San Diego, CA 92121-1979

Phone

(619) 436-4691

Fax

(415) 484-1944

NPI assigned

Apr 3, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1326433525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10531 4SCOMMONS DR 166 541",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92127",
            "telephone_number": "203-507-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 EASTGATE MALL FL 2",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211979",
            "telephone_number": "619-436-4691",
            "fax_number": "415-484-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAZAELI",
        "first_name": "AZIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-03",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A154274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morteza Khatibzadeh
• Yojana Khatiwoda
• Rakhi Khatri, MD
• Eddie Khav, DO
• Huathin Khaw, MD
• Maryam Khazaeli
• KHCS San Diego, Inc.
• Omar Khder, PH.D.
• Bhupinder Khehar, M.D.
• Hamid Kheradmandnia, DDS

• Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.