Active NPI
Mandana Azar, M.D.
- Internal Medicine Physician
- Thousand Oaks, CA
National Provider Identifier
1851612402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A73701
- Practice address
- 425 Haaland Dr Ste 200
Thousand Oaks, CA 91361-5231 - Phone
- (805) 373-7073
- NPI assigned
- Jun 17, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A73701 | CA | Primary |
Addresses
Primary practice location
425 Haaland Dr Ste 200
Thousand Oaks, CA 91361-5231
Mailing address
PO Box 1027
Thousand Oaks, CA 91358-0027
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A73701 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rolling Oaks Surgery Center LLC | Past | Accepting new patients | |
| Kouros Azar, MD a Professional Corporation | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Thousand Oaks, CA
- NPI 1093033987
-
- Ambulatory Surgical Clinic/Center
- Thousand Oaks, CA
- NPI 1003216276
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365638400000",
"number": "1851612402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1027",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913580027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 HAALAND DR STE 200",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913615231",
"telephone_number": "805-373-7073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZAR",
"first_name": "MANDANA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-17",
"last_updated": "2013-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A73701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Thousand Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.