Provider Demographics
NPI:1043362676
Name:ATOZ MEDICAL MANAGMENT
Entity Type:Organization
Organization Name:ATOZ MEDICAL MANAGMENT
Other - Org Name:ANAHEIM HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAYENDRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-484-1280
Mailing Address - Street 1:1125 N MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-2638
Mailing Address - Country:US
Mailing Address - Phone:714-484-1280
Mailing Address - Fax:714-484-1358
Practice Address - Street 1:1125 N MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2638
Practice Address - Country:US
Practice Address - Phone:714-484-1280
Practice Address - Fax:714-484-1358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40490261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center