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General NPI Number Information
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NPI Number | 1932902566
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Entity Type | Individual
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Provider Name | MICHAEL AMARILLAS APRN
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Gender | Male
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Dates
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Enumeration Date | 03/29/2025
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 830 SCENIC DR STE A
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City | MODESTO
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State | CA
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Zip | 95350-6131
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Country | US
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Telephone | 209-558-7000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2502
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City | TURLOCK
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State | CA
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Zip | 95381-2502
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95034357
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License Number State | CA
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