1639231327 NPI number — ACADEMIC MEDICAL RESEARCH INSTITUTE INC

Table of content: (NPI 1639231327)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639231327 NPI number — ACADEMIC MEDICAL RESEARCH INSTITUTE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACADEMIC MEDICAL RESEARCH INSTITUTE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
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Provider Other Credential Text:
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NPI Number Information

NPI Number:
1639231327
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1019
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH PASADENA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91031-1019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-842-5772
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5830 WHITTIER BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90022-4302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-725-0051
Provider Business Practice Location Address Fax Number:
323-869-9245
Provider Enumeration Date:
12/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
EL-SHAHAWY
Authorized Official First Name:
MOHAMED
Authorized Official Middle Name:
ALI
Authorized Official Title or Position:
MEDICAL DIRECTOR & CEO
Authorized Official Telephone Number:
323-725-0051

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , with the licence number:  A042315 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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