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General NPI Number Information
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NPI Number | 1457688699
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Entity Type | Individual
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Provider Name | ARTHUR AMANFO PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/09/2009
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Last Update Date | 11/09/2009
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Provider Practice Location Address
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Address Line | 1173 N DIXIE DR SUITE 101
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City | SAN DIMAS
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State | CA
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Zip | 91773-1200
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Country | US
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Telephone | 909-599-4422
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 S NORTON AVE APT 304
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City | LOS ANGELES
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State | CA
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Zip | 90019-3352
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Country | US
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Telephone | 323-382-2767
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA20657
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License Number State | CA
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