Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 95012887 | CA |
NPI | 1164058897 |
---|---|
Provider Name | Amani A Osman |
First Address | Cypress, CA 90630-4004 |
Second Address | Cypress, CA 90630-4004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2020 |
Last Update Date | 13/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
95012887 | N/A (01) | CA |