| |
1710 S Amphlett Blvd Ste 250 San Mateo CA 94402-2715 | |
(650) 273-4082 | |
(650) 275-7559 |
Full Name | |
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Speciality | Psychiatry & Neurology |
Location | 1710 S Amphlett Blvd Ste 250, San Mateo, California |
Authorized Official Name and Position | Farzana Amin (CEO/OWNER) |
Authorized Official Contact | 3146297696 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1710 S Amphlett Blvd Ste 250 San Mateo CA 94402-2715 Ph: (650) 273-4082 | 1710 S Amphlett Blvd Ste 250 San Mateo CA 94402-2715 Ph: (650) 273-4082 |
NPI Number | 1417685181 |
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Provider Enumeration Date | 08/10/2022 |
Last Update Date | 08/22/2022 |
Certification Date | 08/22/2022 |
Medicare PECOS PAC ID | 6305220427 |
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Medicare Enrollment ID | O20220908001387 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417685181 | NPI | - | NPPES |
Provider Name | Farzana Amin |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1669525911 PECOS PAC ID: 3476656661 Enrollment ID: I20070308000237 |
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