Healthcare Provider Details

I. General information

NPI: 1417685181
Provider Name (Legal Business Name): HEAL MEDICAL WEIGHT LOSS CLINIC CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 GRAND AVE #2306
OAKLAND CA
94612
US

IV. Provider business mailing address

2261 MARKET ST STE 86909
SAN FRANCISCO CA
94114-1612
US

V. Phone/Fax

Practice location:
  • Phone: 650-273-4082
  • Fax: 650-275-7559
Mailing address:
  • Phone: 650-273-4082
  • Fax: 650-275-7559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0002X
TaxonomyObesity Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: FARZANA AMIN
Title or Position: CEO/OWNER
Credential: M.D.
Phone: 314-629-7696