| Dr A Shamani Inc | |
|
5555 Reservoir Dr Ste 312 San Diego CA 92120-5173 | |
| (619) 639-7285 | |
| (619) 639-7286 |
| Full Name | Dr A Shamani Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 5555 Reservoir Dr Ste 312, San Diego, California |
| Authorized Official Name and Position | Azam Shamani (MD) |
| Authorized Official Contact | 6196397285 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr A Shamani Inc 5555 Reservoir Dr Ste 312 San Diego CA 92120-5173 Ph: (619) 639-7285 | Dr A Shamani Inc 5555 Reservoir Dr Ste 312 San Diego CA 92120-5173 Ph: (619) 639-7285 |
| NPI Number | 1477892941 |
|---|---|
| Provider Enumeration Date | 02/04/2013 |
| Last Update Date | 06/19/2015 |
| Medicare PECOS PAC ID | 2961657754 |
|---|---|
| Medicare Enrollment ID | O20130228000127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477892941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A109713 (California) | Primary |
| Provider Name | Azam Shamani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699906032 PECOS PAC ID: 4880856038 Enrollment ID: I20120503000639 |
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