Sunday Azimi

Individual provider Active NPI Rehabilitation Practitioner · Altadena, CA

NPI 1720318124 · NPPES record last updated Oct 24, 2014

Key facts

NPI
1720318124
Entity type
Individual (NPI type 1)
Primary specialty
Rehabilitation Practitioner 225400000X
Practice address
760 Mountain View St
Altadena, CA 91001-4925
Phone
(626) 798-6793
NPI assigned
Jan 6, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Rehabilitation Practitioner 225400000X Yes

Addresses

Primary practice location

760 Mountain View St
Altadena, CA 91001-4925

Mailing address

760 Mountain View St
Altadena, CA 91001-4925

Other providers in Altadena, CA

All providers in Altadena, CA · Rehabilitation Practitioner in California

Sources for this page

Verify at the official NPI Registry.