Organization
BAZ ALLERGY, ASTHMA & SINUS CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALIK N BAZ MD (CEO/PRESIDENT)
(559) 436-4500
Entity
Organization
Contact information
Practice address
2021 HERNDON AVE, SUITE 101, CLOVIS, CA 93611-6101
(559) 436-4500
Mailing address
7471 N FRESNO ST, FRESNO, CA 93720-2457
(559) 436-4500
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0043790
—
CA
01
—
ZZZ21572Z
GRP MCARE PTAN FOR BAZ ALLERGHY ASTHMA SINUS CENTER
CA
Enumeration date
05/04/2015
Last updated
06/10/2017
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