Healthcare Provider Details

I. General information

NPI: 1760981716
Provider Name (Legal Business Name): JOINT PRESERVATION INSTITUTE, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2018
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N WIGET LN STE 200
WALNUT CREEK CA
94598-5901
US

IV. Provider business mailing address

21C ORINDA WAY # 148
ORINDA CA
94563-2534
US

V. Phone/Fax

Practice location:
  • Phone: 925-322-2908
  • Fax: 925-322-2911
Mailing address:
  • Phone: 925-322-2908
  • Fax: 925-322-2911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberA061055
License Number StateCA

VIII. Authorized Official

Name: DR. AMIR A JAMALI
Title or Position: PRESIDENT
Credential: MD
Phone: 925-322-2908