Kazem Aldarawsheh

Individual provider Active NPI Driver · San Bernardino, CA

NPI 1689419699 · NPPES record last updated Jul 1, 2024

Key facts

NPI
1689419699
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
License
F4786644 (CA)
Practice address
765 S Gifford Ave Ste 2
San Bernardino, CA 92408-2461
Phone
(909) 735-1124
NPI assigned
Jul 1, 2024
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
F4786644CAMDDriver

Practice roles

OrganizationSpecialtyStatusNew patients
American Logistics Services Inc Past
since Jul 7, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X F4786644 CA Yes

Addresses

Primary practice location

765 S Gifford Ave Ste 2
San Bernardino, CA 92408-2461

Mailing address

765 S Gifford Ave Ste 2
San Bernardino, CA 92408-2461
Phone (909) 735-1124

Other providers in San Bernardino, CA

All providers in San Bernardino, CA · Driver in California

Sources for this page

Verify at the official NPI Registry.