Healthcare Provider Details

I. General information

NPI: 1497953731
Provider Name (Legal Business Name): AMALIA D FYLES CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE SAN FRANCISC GENERAL HOSP.,1M42
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

1001 POTRERO AVE SAN FRANCISC GENERAL HOSP.,1M42
SAN FRANCISCO CA
94110-3518
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-8749
  • Fax: 415-206-3012
Mailing address:
  • Phone: 415-206-8749
  • Fax: 415-206-3012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number235628
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: