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General NPI Number Information
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NPI Number | 1366730780
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Entity Type | Organization
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Legal Business Name | BAIJU ABDULLA, M.B.B.S., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 1025 N DOUTY ST
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City | HANFORD
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State | CA
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Zip | 93230-3722
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Country | US
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Telephone | 559-583-2254
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Fax | 559-583-2195
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Provider Business Mailing Address
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Address Line | 876 E REDWOOD CIR
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City | HANFORD
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State | CA
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Zip | 93230-2383
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Country | US
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Telephone | 559-422-0004
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BAIJU ABDULLA
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Credential | M.D.
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Telephone | 559-422-0004
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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 | A114035
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License Number State | CA
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