Healthcare Provider Details

I. General information

NPI: 1952632929
Provider Name (Legal Business Name): AMAL K OBAID-SCHMID MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2010
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 S ARROYO PKWY FL 3
PASADENA CA
91105-3932
US

IV. Provider business mailing address

1044 S FAIR OAKS AVE SUITE 101
PASADENA CA
91105-2622
US

V. Phone/Fax

Practice location:
  • Phone: 626-449-4859
  • Fax: 626-403-0321
Mailing address:
  • Phone: 626-449-4859
  • Fax: 626-403-0321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA75419
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberA75419
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberA75419
License Number StateCA

VIII. Authorized Official

Name: AMAL K OBAID-SCHMID
Title or Position: OWNER
Credential: MD
Phone: 626-449-4859