Provider Demographics
NPI:1730441197
Name:SAFWAN ALBOINY MD INC
Entity type:Organization
Organization Name:SAFWAN ALBOINY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAFWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBOINY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-550-6366
Mailing Address - Street 1:605 W H ST
Mailing Address - Street 2:110
Mailing Address - City:BRAWLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92227-4200
Mailing Address - Country:US
Mailing Address - Phone:760-550-6366
Mailing Address - Fax:760-550-6247
Practice Address - Street 1:205 W LEGION RD
Practice Address - Street 2:
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-7780
Practice Address - Country:US
Practice Address - Phone:760-550-6366
Practice Address - Fax:760-550-6247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1134262084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty