Provider Demographics
NPI:1225178494
Name:A.M. AGHA MD INC
Entity type:Organization
Organization Name:A.M. AGHA MD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:MOHAMMAD
Authorized Official - Last Name:AGHAMOHAMMADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-324-3232
Mailing Address - Street 1:2323 16TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3420
Mailing Address - Country:US
Mailing Address - Phone:661-324-3232
Mailing Address - Fax:661-324-1236
Practice Address - Street 1:2323 16TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3420
Practice Address - Country:US
Practice Address - Phone:661-324-3232
Practice Address - Fax:661-324-1236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41243207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ29422ZMedicare PIN
CAY10337Medicare UPIN