Basic Information
| Provider Information | |||||||||
| NPI: | 1528585239 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ABOSHADY IN PATIENT SERVICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5150 E PACIFIC COAST HWY STE 500 | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908043328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5622995200 | ||||||||
| FaxNumber: | 5622995294 | ||||||||
| Practice Location | |||||||||
| Address1: | 3751 KATELLA AVE | ||||||||
| Address2: | |||||||||
| City: | LOS ALAMITOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907203113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9288549603 | ||||||||
| FaxNumber: | 5622995204 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2017 | ||||||||
| LastUpdateDate: | 08/23/2017 | ||||||||
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| AuthorizedOfficialLastName: | MOUSTAFA | ||||||||
| AuthorizedOfficialFirstName: | ABOSHADY | ||||||||
| AuthorizedOfficialMiddleName: | MOATAZ | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9288549603 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.