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Organization

BAZ ALLERGY, ASTHMA & SINUS CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MALIK NASIR BAZ M.D. (CFO/VICE PRESIDENT)
(559) 436-4500
Entity
Organization

Contact information

Practice address
1860 MOWRY AVE STE 400, FREMONT, CA 94538-1730
(510) 894-0051
(510) 894-1578
Mailing address
7471 N FRESNO ST, FRESNO, CA 93720-2457
(559) 436-4500
(559) 261-1526

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
A35393
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0043790
CA
01
ZZZ21572Z
GRP MCARE PTAN FOR BAZ ALLERGY, ASTHMA & SINUS CENTER
CA
Enumeration date
10/26/2015
Last updated
06/10/2017
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