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General NPI Number Information
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NPI Number | 1205208675
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Entity Type | Organization
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Legal Business Name | BAZ ALLERGY, ASTHMA & SINUS CENTER
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 06/10/2017
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Provider Practice Location Address
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Address Line | 1860 MOWRY AVE STE 400
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City | FREMONT
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State | CA
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Zip | 94538-1730
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Country | US
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Telephone | 510-894-0051
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Fax | 510-894-1578
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Provider Business Mailing Address
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Address Line | 7471 N FRESNO ST
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City | FRESNO
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State | CA
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Zip | 93720-2457
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Country | US
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Telephone | 559-436-4500
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Fax | 559-261-1526
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Authorized Official
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Title or Position | CFO/VICE PRESIDENT
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Name | DR. MALIK NASIR BAZ
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Credential | M.D.
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Telephone | 559-436-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | A35393
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License Number State | CA
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