South Auburn Medical Clinic Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

602338317 Issued in WA

Legal business name

SOUTH AUBURN MEDICAL CLINIC INC

Practice address

3830 A St SE Ste 204
Auburn, WA 98002-8611

Phone

(253) 804-9190

Fax

(253) 804-5797

NPI assigned

Mar 22, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Alfred Aflatooni, MD

Title

Ceo President

Phone

(253) 804-9190

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241395200000",
    "number": "1265558993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 A ST SE STE 204",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980028611",
            "telephone_number": "253-804-9190",
            "fax_number": "253-804-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 A ST SE STE 204",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980028611",
            "telephone_number": "253-804-9190",
            "fax_number": "253-804-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH AUBURN MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2009-05-04",
        "status": "A",
        "authorized_official_last_name": "AFLATOONI",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "253-804-9190",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "602338317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "4121SO",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Auburn, WA
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• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.