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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