Amiri, Mariam Shanaz

Amiri, Mariam Shanaz is an sole proprietor health care provider with primary practice located at 11332 Mountain View Ave Suite A, Loma Linda CA 92354-3854. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Amiri, Mariam Shanaz can be contacted via phone (909) 796-3707.

Contact Information

Primary practice address
11332 Mountain View Ave Suite A Loma Linda CA 92354-3854
Phone: (909) 796-3707
Fax: (909) 796-3709
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X E4049 California

Profile Details

NPI number 1093826539
LBN Legal business name Amiri, Mariam Shanaz
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 31st, 2006
Last updated Aug 24th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093826539 NPPES
California MEDICAID 000E40490

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