| Nahel Al Bouz Md A Professional Medical Corp | |
|
811 E 11th St Ste 203 Upland CA 91786-4872 | |
| (909) 581-6420 | |
| (909) 982-2322 |
| Full Name | Nahel Al Bouz Md A Professional Medical Corp |
|---|---|
| Speciality | Internal Medicine |
| Location | 811 E 11th St Ste 203, Upland, California |
| Authorized Official Name and Position | Nahel Al Bouz (CEO) |
| Authorized Official Contact | 5162413595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nahel Al Bouz Md A Professional Medical Corp 671 Redwood Ln San Dimas CA 91773-3624 Ph: (516) 241-3595 | Nahel Al Bouz Md A Professional Medical Corp 811 E 11th St Ste 203 Upland CA 91786-4872 Ph: (909) 581-6420 |
| NPI Number | 1679951578 |
|---|---|
| Provider Enumeration Date | 05/11/2015 |
| Last Update Date | 10/31/2016 |
| Medicare PECOS PAC ID | 7618282674 |
|---|---|
| Medicare Enrollment ID | O20150819009119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679951578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (California) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (California) | Secondary |
| Provider Name | Nahel Al Bouz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326235136 PECOS PAC ID: 8022164243 Enrollment ID: I20090914000170 |
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