MEDICARE: DR. AMOL NARENDRA DOSHI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0901X	Public Health & General Preventive Medicine Physician	AO66904	CA

General Provider Information

NPI Number	:	1164573234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMOL NARENDRA DOSHI MD

Provider Business Mailing Address
First Line	:	SDSU CALPULLI CTR HEALTH SVCS 5500 CAMPANILE DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92182-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	SDSU CALPULLI CTR HEALTH SVCS 5500 CAMPANILE DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92182-0001
Country	:	US
Telephone Number	:	619-594-6681
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	10/09/2009

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