Basic Information
| Provider Information | |||||||||
| NPI: | 1790039733 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABDELAZIZ | ||||||||
| FirstName: | AHMED | ||||||||
| MiddleName: | ABDELAZIZ | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2050 S BLOSSER RD | ||||||||
| Address2: | |||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934587310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8053618028 | ||||||||
| FaxNumber: | 8053618097 | ||||||||
| Practice Location | |||||||||
| Address1: | 1418 E MAIN ST | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934544833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059283678 | ||||||||
| FaxNumber: | 8059286408 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/30/2012 | ||||||||
| LastUpdateDate: | 10/12/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 142800 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VG0400X | 4301101741 | MI | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
No ID Information.