Basic Information
| Provider Information | |||||||||
| NPI: | 1346712775 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AZIZ | ||||||||
| FirstName: | ABDUL | ||||||||
| MiddleName: | MAJID | ||||||||
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| Credential: | MSN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 81557 DR CARREON BLVD STE C9 | ||||||||
| Address2: | |||||||||
| City: | INDIO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922015562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603916999 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 81557 DOCTOR CARREON BLVD STE C9 | ||||||||
| Address2: | |||||||||
| City: | INDIO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922015562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5724355836 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/24/2018 | ||||||||
| LastUpdateDate: | 02/21/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 95010748 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.