Provider Demographics
NPI:1730165564
Name:NAJI BOUZ MD INC & N KASSAR MD INC PTRS
Entity type:Organization
Organization Name:NAJI BOUZ MD INC & N KASSAR MD INC PTRS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAJIB
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-963-4124
Mailing Address - Street 1:315 E ROUTE 66
Mailing Address - Street 2:#201
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-6257
Mailing Address - Country:US
Mailing Address - Phone:626-963-4124
Mailing Address - Fax:626-963-6773
Practice Address - Street 1:315 E ROUTE 66
Practice Address - Street 2:#101
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-6257
Practice Address - Country:US
Practice Address - Phone:626-963-4124
Practice Address - Fax:626-963-6773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0076960Medicaid
CAW11433Medicare ID - Type Unspecified