Healthcare Provider Details

I. General information

NPI: 1508080193
Provider Name (Legal Business Name): A M AMINIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 01/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7375 N FRESNO ST STE 101
FRESNO CA
93720-2478
US

IV. Provider business mailing address

7375 N FRESNO ST STE 101
FRESNO CA
93720-2478
US

V. Phone/Fax

Practice location:
  • Phone: 559-447-1700
  • Fax: 559-447-0121
Mailing address:
  • Phone: 559-447-1700
  • Fax: 559-447-0121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberA040672
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: