Provider Demographics
NPI:1326235136
Name:AL BOUZ, NAHEL (MD)
Entity Type:Individual
Prefix:
First Name:NAHEL
Middle Name:
Last Name:AL BOUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 REDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-3624
Mailing Address - Country:US
Mailing Address - Phone:909-608-2008
Mailing Address - Fax:909-608-7705
Practice Address - Street 1:811 E 11TH ST STE 203
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4872
Practice Address - Country:US
Practice Address - Phone:909-581-6420
Practice Address - Fax:909-982-2322
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA101427207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine