Healthcare Provider Details

I. General information

NPI: 1124288931
Provider Name (Legal Business Name): HANY S. AZIZ M.D., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 04/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 SAN DIMAS ST SUITE B
BAKERSFIELD CA
93301-5724
US

IV. Provider business mailing address

PO BOX 11134
BAKERSFIELD CA
93389-1134
US

V. Phone/Fax

Practice location:
  • Phone: 661-326-9999
  • Fax: 661-326-9011
Mailing address:
  • Phone: 661-589-0296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA89185
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA89185
License Number StateCA

VIII. Authorized Official

Name: HANY S AZIZ
Title or Position: OWNER
Credential: M.D.
Phone: 661-589-0296