Provider Demographics
NPI:1033752852
Name:WESTLAKE AMERICA CLINIC LLC
Entity Type:Organization
Organization Name:WESTLAKE AMERICA CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDELRAHMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDELAZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-293-0282
Mailing Address - Street 1:25125 DETROIT RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2500
Mailing Address - Country:US
Mailing Address - Phone:216-293-0282
Mailing Address - Fax:440-455-9757
Practice Address - Street 1:25125 DETROIT RD STE 100
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2500
Practice Address - Country:US
Practice Address - Phone:216-293-0282
Practice Address - Fax:440-455-9757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-24
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty