Jack Azad,M.D.,Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

JACK AZAD,M.D.,INC.

Practice address

11900 Avalon Blvd Ste 101
Los Angeles, CA 90061-2867

Phone

(323) 756-1317

Fax

(323) 756-4015

NPI assigned

Jul 22, 2005

Organization subpart

No

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

Authorized official

Name

Jack Azad, M.D.NPI 1841489440

Title

President

Phone

(323) 756-1317

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tri-City Medical Group Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jack Azad, M.D.

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1841489440
  NPD Authorized official

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623715200000",
    "number": "1891795613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 AVALON BLVD",
            "address_2": "#100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900612867",
            "telephone_number": "323-756-1317",
            "fax_number": "323-756-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 AVALON BLVD STE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900612867",
            "telephone_number": "323-756-1317",
            "fax_number": "323-756-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK AZAD,M.D.,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-22",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A",
        "authorized_official_last_name": "AZAD",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-756-1317",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0A544334",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri-City Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Jasmine Jacinto
• Mayra Jacinto
• Nancy Jacinto
• Rudell Gary Santos Jacinto, D.M.D.
• Yobany Jacinto
• Jack Baum MD Inc
• Jack Li, D.C., a Chiropractic Corporation
• Jack Rothberg MD a Medical Copt
• Jack S Kao MD Inc
• Jack Wax, M.D., Inc

• General Practice Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.