Provider Demographics
NPI:1497179865
Name:AMEEN, FAAIDAH
Entity Type:Individual
Prefix:MS
First Name:FAAIDAH
Middle Name:
Last Name:AMEEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 W FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90047-2209
Mailing Address - Country:US
Mailing Address - Phone:323-758-8801
Mailing Address - Fax:
Practice Address - Street 1:1446 W FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90047-2209
Practice Address - Country:US
Practice Address - Phone:323-758-8801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker