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General NPI Number Information
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NPI Number | 1366499832
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Entity Type | Organization
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Legal Business Name | A AMOLI MD INC
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 6170 THORNTON AVE SUITE H
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City | NEWARK
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State | CA
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Zip | 94560-3700
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Country | US
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Telephone | 510-636-1622
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Fax | 510-857-5847
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Provider Business Mailing Address
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Address Line | 6170 THORNTON AVE SUITE H
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City | NEWARK
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State | CA
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Zip | 94560-3700
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Country | US
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Telephone | 510-636-1622
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Fax | 510-857-5847
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Authorized Official
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Title or Position | FAMILY PRACTICE
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Name | DR. HOSSEIN ABED AMOLI
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Credential | M.D.
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Telephone | 510-636-1622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A56121
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License Number State | CA
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