Healthcare Provider Details

I. General information

NPI: 1598161382
Provider Name (Legal Business Name): AMIR BELSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2014
Last Update Date: 11/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1916 FALLEN LEAF LN
LOS ALTOS CA
94024-7206
US

IV. Provider business mailing address

1916 FALLEN LEAF LN
LOS ALTOS CA
94024-7206
US

V. Phone/Fax

Practice location:
  • Phone: 408-621-2454
  • Fax:
Mailing address:
  • Phone: 408-621-2454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA72553
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: