Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | A85206 | CA |
N | 207K00000X | Allergist & Immunologist | MD60134912 | WA |
N | 207R00000X | Internist | A85206 | CA |
N | 111NI0900X | Internist | A85206 | CA |
NPI | 1083748685 |
---|---|
Provider Name | Dr. Ali Amirzadeh |
First Address | Rancho Cordova, CA 95670-7956 |
Second Address | Sacramento, CA 95816-7058 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 29/10/2018 |