Provider Demographics
NPI:1629257530
Name:AMIN, MARLI (MD)
Entity Type:Individual
Prefix:DR
First Name:MARLI
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 1:13950 MILTON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-2900
Mailing Address - Country:US
Mailing Address - Phone:714-702-3000
Mailing Address - Fax:
Practice Address - Street 1:13950 MILTON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-2900
Practice Address - Country:US
Practice Address - Phone:714-702-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101312207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA101312OtherCA MEDICAL LICENSE