Provider Demographics
NPI:1427769165
Name:AZIZI, DANIELLA (PA-C)
Entity type:Individual
Prefix:
First Name:DANIELLA
Middle Name:
Last Name:AZIZI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 S CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4505
Mailing Address - Country:US
Mailing Address - Phone:310-734-9664
Mailing Address - Fax:
Practice Address - Street 1:447 S CRESCENT DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4505
Practice Address - Country:US
Practice Address - Phone:310-734-9664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program