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General NPI Number Information
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NPI Number | 1669933776
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Entity Type | Organization
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Legal Business Name | PRAXIS INFECTIOUS DISEASES
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Dates
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Enumeration Date | 03/29/2019
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 5176 HILL RD E
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City | LAKEPORT
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State | CA
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Zip | 95453-6357
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Country | US
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Telephone | 628-600-3589
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Fax |
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Provider Business Mailing Address
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Address Line | 1141 CATALINA DR # 194
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City | LIVERMORE
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State | CA
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Zip | 94550-5928
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Country | US
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Telephone | 628-600-3589
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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. FAREED RAMZI ASFOUR
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Credential | MD
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Telephone | 628-600-3589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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