Provider Demographics
NPI:1457386294
Name:ARAIN, MOHAMMAD AFZAL
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:AFZAL
Last Name:ARAIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 W YOSEMITE AVE
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-4584
Mailing Address - Country:US
Mailing Address - Phone:559-673-8001
Mailing Address - Fax:559-673-8682
Practice Address - Street 1:1019 W YOSEMITE AVE
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-4584
Practice Address - Country:US
Practice Address - Phone:559-673-8001
Practice Address - Fax:559-673-8682
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32711208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA26903Medicare UPIN