Mardini, Mazen Muhammad
Mardini, Mazen Muhammad is an sole proprietor health care provider with primary practice located at 999 S Fairmont Ave #115, Lodi CA 95240. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Mardini, Mazen Muhammad can be contacted via phone (209) 334-6325.Contact Information
Primary practice address
999 S Fairmont Ave #115
Lodi CA 95240
Phone: (209) 334-6325
Fax: (209) 334-4651
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | A35332 | California |
Profile Details
| NPI number | 1518909126 |
|---|---|
| LBN Legal business name | Mardini, Mazen Muhammad |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 11th, 2006 |
| Last updated | Mar 3rd, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518909126 | NPPES |
| Other | 942676155 | FED ID | |
| MEDICAID | 00A353320 | FED ID |
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