Alan R Nili D O A Professional Corporation | |
18 Endeavor Suite 307 Irvine CA 92618-3164 | |
(949) 260-0106 | |
(949) 260-0105 |
Full Name | Alan R Nili D O A Professional Corporation |
---|---|
Speciality | Family Medicine |
Location | 18 Endeavor, Irvine, California |
Authorized Official Name and Position | Alan R. Nili (OWNER) |
Authorized Official Contact | 9492600106 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Alan R Nili D O A Professional Corporation Po Box 2795 Suisun City CA 94585-5795 Ph: (657) 241-3600 | Alan R Nili D O A Professional Corporation 18 Endeavor Suite 307 Irvine CA 92618-3164 Ph: (949) 260-0106 |
NPI Number | 1497944128 |
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Provider Enumeration Date | 10/18/2007 |
Last Update Date | 08/23/2024 |
Medicare PECOS PAC ID | 6800823394 |
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Medicare Enrollment ID | O20050726001222 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497944128 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | BN5296036 (California) | Primary |
Provider Name | Alan R Nili |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1356366835 PECOS PAC ID: 4082642574 Enrollment ID: I20050727000340 |
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