Provider Demographics
NPI:1699107706
Name:RASOUL SCHOLZ MD A MEDICAL CORPORATION
Entity type:Organization
Organization Name:RASOUL SCHOLZ MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RASOUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-339-9022
Mailing Address - Street 1:PO BOX 55243
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95205-8743
Mailing Address - Country:US
Mailing Address - Phone:209-339-9022
Mailing Address - Fax:209-339-9033
Practice Address - Street 1:1006 NUT TREE RD
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4100
Practice Address - Country:US
Practice Address - Phone:209-339-9022
Practice Address - Fax:209-339-9033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-31
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77903261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA77903OtherMEDICAL LICENSE