Provider Demographics
NPI:1265965784
Name:E-SOLUTIONS MEDICAL CORP., A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:E-SOLUTIONS MEDICAL CORP., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-712-0030
Mailing Address - Street 1:631 S BROOKHURST ST
Mailing Address - Street 2:STE 201
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3510
Mailing Address - Country:US
Mailing Address - Phone:562-739-5959
Mailing Address - Fax:
Practice Address - Street 1:631 S BROOKHURST ST
Practice Address - Street 2:STE 201
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3510
Practice Address - Country:US
Practice Address - Phone:562-739-5959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44522207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty