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General NPI Number Information
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NPI Number | 1265558993
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Entity Type | Organization
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Legal Business Name | SOUTH AUBURN MEDICAL CLINIC INC
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 05/04/2009
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Provider Practice Location Address
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Address Line | 3830 A ST SE STE 204
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City | AUBURN
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State | WA
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Zip | 98002-8611
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Country | US
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Telephone | 253-804-9190
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Fax | 253-804-5797
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Provider Business Mailing Address
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Address Line | 3830 A ST SE STE 204
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City | AUBURN
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State | WA
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Zip | 98002-8611
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Country | US
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Telephone | 253-804-9190
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Fax | 253-804-5797
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Authorized Official
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Title or Position | CEO PRESIDENT
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Name | DR. ALFRED AFLATOONI
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Credential | MD
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Telephone | 253-804-9190
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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 | 602338317
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License Number State | WA
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