Provider Demographics
NPI:1093067084
Name:KAMBIZ AFLATOON DO
Entity Type:Organization
Organization Name:KAMBIZ AFLATOON DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMBIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:AFLATOON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-535-8363
Mailing Address - Street 1:2150 PEACHFORD HOSPITAL
Mailing Address - Street 2:SUITE A
Mailing Address - City:ATLLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6521
Mailing Address - Country:US
Mailing Address - Phone:770-674-0553
Mailing Address - Fax:
Practice Address - Street 1:2150 PEACHFORD RD
Practice Address - Street 2:SUITE A
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6520
Practice Address - Country:US
Practice Address - Phone:770-674-0554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-15
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA662382084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty