Provider Demographics
NPI:1114065042
Name:NAGUI ACHAMALLAH MD, INC.
Entity Type:Organization
Organization Name:NAGUI ACHAMALLAH MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAGUI
Authorized Official - Middle Name:
Authorized Official - Last Name:ACHAMALLAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-681-2645
Mailing Address - Street 1:1000 BURNETT AVE
Mailing Address - Street 2:SUITE 435
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520
Mailing Address - Country:US
Mailing Address - Phone:925-681-2645
Mailing Address - Fax:925-681-2645
Practice Address - Street 1:1000 BURNETT AVE
Practice Address - Street 2:SUITE 435
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520
Practice Address - Country:US
Practice Address - Phone:925-681-2645
Practice Address - Fax:925-681-2645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA489882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty