Individual provider Active NPI

Tamer M Abdel-Azim, DDS

  • Prosthodontics
  • San Francisco, CA
National Provider Identifier
1417263286
Registry record updated Jun 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
64670 Issued in CA
Practice address
586 Washington St
San Francisco, CA 94111-2929
Phone
(415) 590-7485
Fax
(415) 590-7489
NPI assigned
Aug 31, 2010
Last updated
Jun 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 64670 CA Primary

Addresses

Primary practice location

586 Washington St
San Francisco, CA 94111-2929

Mailing address

PO Box 2921
San Francisco, CA 94126-2921
Phone (415) 590-7485

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
64670CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466899200000",
    "number": "1417263286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2921",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941262921",
            "telephone_number": "415-590-7485",
            "fax_number": "415-590-7489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 WASHINGTON ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941112929",
            "telephone_number": "415-590-7485",
            "fax_number": "415-590-7489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDEL-AZIM",
        "first_name": "TAMER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-31",
        "last_updated": "2016-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "64670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2016; 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.