Provider Demographics
NPI:1679248454
Name:ABDELGHANI PULMONARY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:ABDELGHANI PULMONARY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-464-6422
Mailing Address - Street 1:1801 E MARCH LN STE C300
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210-6657
Mailing Address - Country:US
Mailing Address - Phone:209-464-6422
Mailing Address - Fax:209-464-0193
Practice Address - Street 1:1801 E MARCH LN STE C300
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-6657
Practice Address - Country:US
Practice Address - Phone:209-464-6422
Practice Address - Fax:209-464-0193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty