Healthcare Provider Details

I. General information

NPI: 1134034598
Provider Name (Legal Business Name): AMALI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 ORANGE AVE STE 311
CORONADO CA
92118-2949
US

IV. Provider business mailing address

1330 ORANGE AVE STE 311
CORONADO CA
92118-2949
US

V. Phone/Fax

Practice location:
  • Phone: 619-782-3736
  • Fax:
Mailing address:
  • Phone: 619-782-3736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: TAYLOR KUGEL
Title or Position: ASSOCIATE EXECUTIVE DIRECTOR
Credential:
Phone: 619-782-3736