Provider Demographics
NPI:1063722627
Name:THE ADVANCED MEDICAL INSTITUTE
Entity type:Organization
Organization Name:THE ADVANCED MEDICAL INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAZIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:AL-HAKEEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-969-2520
Mailing Address - Street 1:19671 BEACH BLVD.
Mailing Address - Street 2:SUITE 321
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648
Mailing Address - Country:US
Mailing Address - Phone:714-969-2520
Mailing Address - Fax:714-969-7480
Practice Address - Street 1:19671 BEACH BLVD.
Practice Address - Street 2:SUITE 321
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-5930
Practice Address - Country:US
Practice Address - Phone:714-969-2520
Practice Address - Fax:714-969-7480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical