Healthcare Provider Details

I. General information

NPI: 1437577871
Provider Name (Legal Business Name): AMADALIS INVESTMENTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 04/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

632 PINRAIL LN
FOSTER CITY CA
94404-4608
US

IV. Provider business mailing address

632 PINRAIL LN
FOSTER CITY CA
94404-4608
US

V. Phone/Fax

Practice location:
  • Phone: 805-907-9093
  • Fax:
Mailing address:
  • Phone: 805-907-9093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. LUIS HERNANDEZ
Title or Position: VP FINANCE
Credential:
Phone: 650-784-0460