Sandra Dawn Kazim, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

335697 Issued in CA

Practice address

200 W Center Street Promenade
Anaheim, CA 92805-3960

Phone

(714) 712-9559

NPI assigned

Nov 18, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1508230244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "964 JUNIPERO DR",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265839",
            "telephone_number": "714-442-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W CENTER STREET PROMENADE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053960",
            "telephone_number": "714-712-9559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZIM",
        "first_name": "SANDRA",
        "middle_name": "DAWN",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "335697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kay Choi M.D., Inc.
• Kaitlin Kay, LCSW
• Kaye Omid DDS PC
• Zina Kayyal
• Mary Ann Kazem, NP
• Kci USA, Inc.
• KCS, Inc.
• KCS, Inc.
• KCS, Inc.
• KCS, Inc.

• Nurse Practitioner in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.