Healthcare Provider Details

I. General information

NPI: 1932442944
Provider Name (Legal Business Name): AHMAD ABDELAZIZ ABOAZIZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W MINERAL KING AVE
VISALIA CA
93291-6237
US

IV. Provider business mailing address

9300 VALLEY CHILDRENS PL # SC05
MADERA CA
93636-8761
US

V. Phone/Fax

Practice location:
  • Phone: 559-624-2245
  • Fax:
Mailing address:
  • Phone: 559-353-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2016-01800
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberA138964
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: