| Farah A Ameeri D O Inc | |
|
13768 Roswell Ave Suite 115 Chino CA 91710-1401 | |
| (909) 364-0060 | |
| (909) 364-1126 |
| Full Name | Farah A Ameeri D O Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 13768 Roswell Ave, Chino, California |
| Authorized Official Name and Position | Farah A Ameeri (OWNER) |
| Authorized Official Contact | 9093640600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Farah A Ameeri D O Inc 13768 Roswell Ave Suite 115 Chino CA 91710-1401 Ph: (909) 364-0060 | Farah A Ameeri D O Inc 13768 Roswell Ave Suite 115 Chino CA 91710-1401 Ph: (909) 364-0060 |
| NPI Number | 1679591598 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 06/21/2018 |
| Medicare PECOS PAC ID | 5597778969 |
|---|---|
| Medicare Enrollment ID | O20060801000416 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679591598 | NPI | - | NPPES |
| 20A7860 | Other | CA | LICENSE |
| 10940264 | Other | CA | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20A7860 (California) | Primary |
| Provider Name | Farah A Ameeri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023054699 PECOS PAC ID: 6507813524 Enrollment ID: I20050401000553 |
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