Organization
AWESOME BLESSINGS MEDICAL CLINIC, INC.
Active
Other names
Awesome Blessings Medical Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THAN AYE AW M.D (OWNER)
(559) 905-9087
Entity
Organization
Contact information
Practice address
595 ESTUDILLO AVE, SAN LEANDRO, CA 94577-4611
(510) 483-5881
(510) 483-7114
Mailing address
595 ESTUDILLO AVE, SAN LEANDRO, CA 94577-4611
(510) 483-5881
(510) 483-7114
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
A53206
CA
261QP2300X
Primary Care Clinic/Center
A53206
CA
261QP3300X
Pain Clinic/Center
A53206
CA
Other
Enumeration date
12/11/2007
Last updated
04/01/2009
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