Provider Demographics
NPI:1043452782
Name:AMIN, LOULA (MD)
Entity Type:Individual
Prefix:
First Name:LOULA
Middle Name:
Last Name:AMIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 WESTCLIFF DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5599
Mailing Address - Country:US
Mailing Address - Phone:949-645-3374
Mailing Address - Fax:949-645-2410
Practice Address - Street 1:2011 WESTCLIFF DR
Practice Address - Street 2:SUITE 7
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5599
Practice Address - Country:US
Practice Address - Phone:949-645-3374
Practice Address - Fax:949-645-2410
Is Sole Proprietor?:No
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA25565207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology