Provider Demographics
NPI:1982733929
Name:AZZUZ, LAILA AHMED (MD)
Entity type:Individual
Prefix:DR
First Name:LAILA
Middle Name:AHMED
Last Name:AZZUZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NONE
Other - Middle Name:NONE
Other - Last Name:NONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:348 MERIDIAN DR
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94065-2818
Mailing Address - Country:US
Mailing Address - Phone:650-592-2214
Mailing Address - Fax:
Practice Address - Street 1:348 MERIDIAN DR
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94065-2818
Practice Address - Country:US
Practice Address - Phone:650-573-2669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98591208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics