MEDICARE: AHMADALI HAMIDI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	34392	MN

General Provider Information

NPI Number	:	1326024563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMADALI HAMIDI MD

Provider Business Mailing Address
First Line	:	PO BOX 27206
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-0206
Country	:	US
Telephone Number	:	213-385-0675
Fax Number	:	323-365-6429

Provider Business Practice Location Address
First Line	:	13754 VICTORY BLVD
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91401-2324
Country	:	US
Telephone Number	:	818-616-1373
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	04/22/2020

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