Healthcare Provider Details

I. General information

NPI: 1891114799
Provider Name (Legal Business Name): AMANDA MCNALLY UBER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA CATHERINE MCNALLY

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 WELCH RD
PALO ALTO CA
94304-1601
US

IV. Provider business mailing address

6853 E OSBORN RD UNIT C
SCOTTSDALE AZ
85251-6211
US

V. Phone/Fax

Practice location:
  • Phone: 650-497-8000
  • Fax:
Mailing address:
  • Phone: 303-717-5461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A14351
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number13103616-1204
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: