Healthcare Provider Details

I. General information

NPI: 1750540621
Provider Name (Legal Business Name): ADIL N IRANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 02/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 MOWRY AVE. SUITE 309
FREMONT CA
94538-1722
US

IV. Provider business mailing address

1900 MOWRY AVE. SUITE 309
FREMONT CA
94538-1722
US

V. Phone/Fax

Practice location:
  • Phone: 510-796-0222
  • Fax: 510-796-7760
Mailing address:
  • Phone: 510-796-0222
  • Fax: 510-796-7760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA75847
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA75847
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: