Muhammad Anwarul Azam, M.D.
Individual provider Active NPI Family Medicine Physician · El Cajon, CA
NPI 1740244367 · NPPES record last updated Jul 22, 2014
Key facts
- NPI
- 1740244367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A52314 (CA)
- Practice address
- 1679 E Main St
Suite 206
El Cajon, CA 92021-5212 - Phone
- (619) 579-6300
- Fax
- (619) 579-0040
- NPI assigned
- Apr 12, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1983
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1679 E Main St
Suite 206
El Cajon, CA 92021-5213
Hospital & facility affiliations
- Grossmont Hospital
- Sharp Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130311000429 | CA | Practitioner - Family Practice | 8527213925 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A52314 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sharp Memorial Hospital | Past | Accepting new patients | |
| Grossmont Hospital Corporation | Past | Accepting new patients |
Interoperability endpoints
- mazam34082@sharphealthcare.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A52314 | CA | Yes |
Addresses
Primary practice location
1679 E Main St
Suite 206
El Cajon, CA 92021-5212
Mailing address
1679 E Main St
Suite 206
El Cajon, CA 92021-5212
Phone (619) 579-6300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A0052314 | Medicaid | CA | |
| A52314 | Other | CA | MEDICAL LICENSE |
Other providers in El Cajon, CA
- Liberty Thi Awa
- Halimah Awawda
- Alan Awdisho
- Aeven Amir Awraha
- Andi Ayala-Castillo
- Raid E Azez
- Monica Aziz
- Widad Zuhar Aziz
- Rani Fakhri Azzo
- Kirsten Ashlee Baas
All providers in El Cajon, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.