Provider Demographics
NPI:1528605938
Name:AZEEM, ARIF (AA SAC TRANSPORT)
Entity Type:Individual
Prefix:
First Name:ARIF
Middle Name:
Last Name:AZEEM
Suffix:
Gender:M
Credentials:AA SAC TRANSPORT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2455 WEST CAPITOL AVE#123
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691
Mailing Address - Country:US
Mailing Address - Phone:916-718-5986
Mailing Address - Fax:916-242-4467
Practice Address - Street 1:2455 W CAPITOL AVE APT 123
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-2379
Practice Address - Country:US
Practice Address - Phone:916-718-5986
Practice Address - Fax:916-242-4467
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)