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General NPI Number Information
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NPI Number | 1164748513
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Entity Type | Organization
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Legal Business Name | A.N.A. MEDICAL ASSOCIATES INC
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Dates
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Enumeration Date | 04/09/2010
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Last Update Date | 01/03/2014
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Provider Practice Location Address
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Address Line | 2777 PACIFIC AVE SUITE N
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City | LONG BEACH
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State | CA
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Zip | 90806-2625
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Country | US
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Telephone | 562-424-8199
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Fax |
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Provider Business Mailing Address
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Address Line | 2777 PACIFIC AVE SUITE N
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City | LONG BEACH
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State | CA
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Zip | 90806-2625
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Country | US
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Telephone | 562-424-8199
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Fax |
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Authorized Official
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Title or Position | OWNER/
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Name | DR. AZRA AFREEN NISAR
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Credential | M.D.
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Telephone | 562-424-8199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A41503
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License Number State | CA
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