Basic Information
| Provider Information | |||||||||
| NPI: | 1851055305 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AAA MEDICAL CORP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2160 N STOKES CT | ||||||||
| Address2: | |||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932918495 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5712772091 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1800 N CALIFORNIA ST | ||||||||
| Address2: | |||||||||
| City: | STOCKTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 952046019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2099432000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2021 | ||||||||
| LastUpdateDate: | 10/29/2021 | ||||||||
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| AuthorizedOfficialLastName: | ABOAZIZA | ||||||||
| AuthorizedOfficialFirstName: | AHMAD | ||||||||
| AuthorizedOfficialMiddleName: | ABDELAZIZ | ||||||||
| AuthorizedOfficialTitleorPosition: | AUTHORIZED OFFICIAL/SOLE OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5712772091 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 10/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080N0001X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
No ID Information.