Organization
MADERA FAMILY MEDICAL GROUP LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AFTAB A NAZ M.D. (PRESIDENT)
(559) 673-3000
Entity
Organization
Contact information
Practice address
1111 W 4TH ST, MADERA, CA 93637-4474
(559) 673-3000
(559) 662-2910
Mailing address
1111 W 4TH ST, MADERA, CA 93637-4474
(559) 673-3000
(559) 662-2910
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF11180
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB13493F
—
CA
Enumeration date
01/22/2008
Last updated
01/22/2008
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