Provider Demographics
NPI:1578626909
Name:ATTIA, AMIN (MD)
Entity Type:Individual
Prefix:MR
First Name:AMIN
Middle Name:
Last Name:ATTIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 TOWN AND COUNTRY DR STE 104
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-3611
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2250 S MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-2538
Practice Address - Country:US
Practice Address - Phone:951-734-3233
Practice Address - Fax:951-734-5284
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44842207RR0500X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1578626909Medicaid
00A448420Medicare ID - Type Unspecified
E24807Medicare UPIN