MEDICARE: HAMID REZA AMIRI PHARMACIST

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	183500000X	Pharmacist	39354	CA
2	183500000X	Pharmacist	25480	TX

General Provider Information

NPI Number	:	1639324635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAMID REZA AMIRI PHARMACIST

Provider Business Mailing Address
First Line	:	580 BAILEY RD
Second Line	:
City	:	BAY POINT
State	:	CA
Zip	:	94565-4304
Country	:	US
Telephone Number	:	925-458-0955
Fax Number	:	925-458-5348

Provider Business Practice Location Address
First Line	:	580 BAILEY RD
Second Line	:
City	:	BAY POINT
State	:	CA
Zip	:	94565-4304
Country	:	US
Telephone Number	:	925-458-0955
Fax Number	:	925-458-5348

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

Provider Enumeration Date	:	11/18/2008
Last Update Date	:	11/18/2008

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Directions to “ HAMID REZA AMIRI PHARMACIST” Practice Location

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