Healthcare Provider Details

I. General information

NPI: 1659764678
Provider Name (Legal Business Name): A-Z PROFESSIONAL RESOURCES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2015
Last Update Date: 10/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2617 E CHAPMAN AVE SUITE #101
ORANGE CA
92869-3226
US

IV. Provider business mailing address

PO BOX 61326
IRVINE CA
92602-6044
US

V. Phone/Fax

Practice location:
  • Phone: 714-365-8587
  • Fax: 888-371-1866
Mailing address:
  • Phone: 888-268-8607
  • Fax: 951-461-7074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALBERT LAI
Title or Position: OWNER
Credential: MD
Phone: 888-268-8607