Provider Demographics
NPI:1255041018
Name:E.T. MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:E.T. MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADNAN
Authorized Official - Middle Name:GHASSAN
Authorized Official - Last Name:ABDELAZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-640-6270
Mailing Address - Street 1:12228 CHORUS DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-8757
Mailing Address - Country:US
Mailing Address - Phone:818-640-6270
Mailing Address - Fax:909-941-1211
Practice Address - Street 1:8300 UTICA AVE # 157B
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3879
Practice Address - Country:US
Practice Address - Phone:909-941-1511
Practice Address - Fax:909-941-1211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health