Healthcare Provider Details

I. General information

NPI: 1427073774
Provider Name (Legal Business Name): ALI AMIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 NE 10TH ST
OKLAHOMA CITY OK
73104-5417
US

IV. Provider business mailing address

PO BOX 4985
LANCASTER PA
17604-4985
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-7001
  • Fax:
Mailing address:
  • Phone: 717-391-7092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number46812
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD045969L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: