Healthcare Provider Details

I. General information

NPI: 1720634652
Provider Name (Legal Business Name): LIVIU AMARIEI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 MALL DR
HANFORD CA
93230-5786
US

IV. Provider business mailing address

563 W ORANGE ST
KINGSBURG CA
93631-2690
US

V. Phone/Fax

Practice location:
  • Phone: 559-582-9000
  • Fax:
Mailing address:
  • Phone: 559-375-2256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number95001176
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: