Healthcare Provider Details

I. General information

NPI: 1396328779
Provider Name (Legal Business Name): BAZ ALLERGY, ASTHMA & SINUS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 06/03/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 W SHAW AVE STE A
CLOVIS CA
93612-3229
US

IV. Provider business mailing address

7471 N FRESNO ST
FRESNO CA
93720-2457
US

V. Phone/Fax

Practice location:
  • Phone: 559-436-4500
  • Fax: 559-261-1526
Mailing address:
  • Phone: 559-436-4500
  • Fax: 559-261-1526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MALIK NASIR BAZ
Title or Position: OWNER
Credential:
Phone: 559-436-4500