Provider Demographics
NPI:1316234693
Name:KAZZAZ, NAYEF MOHAMMED A (MD)
Entity type:Individual
Prefix:
First Name:NAYEF
Middle Name:MOHAMMED A
Last Name:KAZZAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6180 BROCKTON AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2233
Mailing Address - Country:US
Mailing Address - Phone:951-781-7700
Mailing Address - Fax:951-781-0313
Practice Address - Street 1:6180 BROCKTON AVE STE 204
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2233
Practice Address - Country:US
Practice Address - Phone:951-781-7700
Practice Address - Fax:951-781-0313
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY51325207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine