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NPI Code Detail

MEDICARE: AJ MEDICAL SOLUTIONS, LLC

MEDICARE: AJ MEDICAL SOLUTIONS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207PS0010XSports Medicine (Emergency Medicine) Physician
2207QS0010XSports Medicine (Family Medicine) Physician
3207RS0010XSports Medicine (Internal Medicine) Physician

General Provider Information

NPI Number : 1063100394
Entity Type Code : Organization
Provider Name (Legal Business Name) : AJ MEDICAL SOLUTIONS, LLC
Provider Business Mailing Address
First Line : 7251 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-1632
Country : US
Telephone Number : 702-497-5971
Fax Number : 702-233-1793
Provider Business Practice Location Address
First Line : 6315 S RAINBOW BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-3216
Country : US
Telephone Number : 702-497-5971
Fax Number : 702-233-1793
Authorized Official
Title or Position : OFFICER
Name : AZAM HAKIM
Credential :
Telephone Number : 702-497-5971
Provider Enumeration Date : 04/25/2023
Last Update Date : 04/25/2023

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