Healthcare Provider Details

I. General information

NPI: 1326263625
Provider Name (Legal Business Name): ANAHEIM HEALTH MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 01/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3055 W ORANGE AVE STE 103
ANAHEIM CA
92804-3152
US

IV. Provider business mailing address

3055 W ORANGE AVE STE 103
ANAHEIM CA
92804-3152
US

V. Phone/Fax

Practice location:
  • Phone: 714-995-2901
  • Fax: 714-995-5474
Mailing address:
  • Phone: 714-995-2901
  • Fax: 714-995-5474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA46393
License Number StateCA

VIII. Authorized Official

Name: DR. AHMED BADR
Title or Position: OWNER
Credential: M.D.
Phone: 714-995-2901