MEDICARE: ALZ MEDICAL RESOURCE NETWORK INC

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
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1386066884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALZ MEDICAL RESOURCE NETWORK INC

Provider Business Mailing Address
First Line	:	2005 PALO VERDE AVE # 319
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-3322
Country	:	US
Telephone Number	:	562-728-3431
Fax Number	:

Provider Business Practice Location Address
First Line	:	2005 PALO VERDE AVE # 319
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-3322
Country	:	US
Telephone Number	:	562-728-3431
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. MOHAMED R ZAVAHIR
Credential	:	RN, BSN, PHN
Telephone Number	:	562-728-3431

Provider Enumeration Date	:	01/17/2014
Last Update Date	:	01/17/2014

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