Provider Demographics
NPI:1316137573
Name:DR. SALMA AZIZ DPM, MS, INC.
Entity type:Organization
Organization Name:DR. SALMA AZIZ DPM, MS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SALMA
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:949-755-8505
Mailing Address - Street 1:22032 EL PASEO
Mailing Address - Street 2:SUITE 140
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-3947
Mailing Address - Country:US
Mailing Address - Phone:949-766-8505
Mailing Address - Fax:949-766-5782
Practice Address - Street 1:22032 EL PASEO
Practice Address - Street 2:SUITE 140
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-3947
Practice Address - Country:US
Practice Address - Phone:949-766-8505
Practice Address - Fax:949-766-5782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE-4233213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWE4233AMedicare PIN
CAU78990Medicare UPIN