ADVANCED FAMILY MEDICINE, PLLC

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Company Details

Legal Name:	ADVANCED FAMILY MEDICINE, PLLC
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Active
Formation/ Registration Date:	December 8th 1997
Expiration date:	31 Dec 2025
UBI Number:	601 837 278
ZIP code:	98052
City:	Redmond
County:	KING
Home State:	WASHINGTON
Principal Office Street Address:	2007 152ND AVE NE, REDMOND, WA, 98052-5521, UNITED STATES
Supporting healthcare providers fighting with COVID-19:	$5,112

Contact Details

E-Mail:	INTERNALMED.MD@GMAIL.COM
Phone Number:	+1 425-453-6838

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
SULEMAN AZIZ	Registered Agent	2007 152ND AVE NE, REDMOND, WA, 98052-5521, UNITED STATES

Key Officers & Management

Name	Role
SULEMAN AZIZ	Governing Person
SHAISTA ZAMAN	Governing Person

National Provider Identifier

NPI Number:

1376763433

Link:

View on NPI website

Authorized Person:

Name:

IRINE VAIMAN

Role:

MEDICAL DIRECTOR

Phone:

4254536838

Taxonomy:

Selected Taxonomy:

213E00000X - Podiatrist

Is Primary:

Yes

Contacts:

Phone:

+1 425-453-6838

Fax:

4254560106

Form 5500 Series

Employer Identification Number (EIN):

911875452

Plan Year:

2012

Number Of Participants:

19

Sponsor's telephone number:

4254536838

File:

Plan Administrator / Signatory:

JACOB GRINBERG(Plan administrator) JACOB GRINBERG(Employer/plan sponsor)

Plan Year:

2012

Number Of Participants:

22

Sponsor's telephone number:

4254536838

File:

Plan Administrator / Signatory:

JACOB GRINBERG(Plan administrator) JACOB GRINBERG(Employer/plan sponsor)

Plan Year:

2011

Number Of Participants:

23

Sponsor's telephone number:

4254536838

File:

Plan Administrator / Signatory:

JACOB GRINBERG(Plan administrator) JACOB GRINBERG(Employer/plan sponsor)

Plan Year:

2010

Number Of Participants:

20

Sponsor's telephone number:

4254536838

File:

Plan Administrator / Signatory:

JACOB GRINBERG(Plan administrator) JACOB GRINBERG(Employer/plan sponsor)

Plan Year:

2009

Number Of Participants:

21

Sponsor's telephone number:

4254536838

File:

Plan Administrator / Signatory:

JACOB GRINBERG(Plan administrator) JACOB GRINBERG(Employer/plan sponsor)

Paycheck Protection Program

Jobs Reported:

18

Initial Approval Amount:

$161,865

Date Approved:

2020-04-30

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$161,865

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$163,257.48

Servicing Lender:

Bank of America, National Association

Use of Proceeds:

Payroll: $161,865

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