Provider Demographics
NPI:1710762562
Name:AMY CHIOU AMINLARI
Entity Type:Organization
Organization Name:AMY CHIOU AMINLARI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:CHIOU
Authorized Official - Last Name:AMINLARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-375-8746
Mailing Address - Street 1:1551 CALLE DE ANDLUCA
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-7110
Mailing Address - Country:US
Mailing Address - Phone:858-335-3110
Mailing Address - Fax:949-502-8887
Practice Address - Street 1:888 PROSPECT ST STE 200
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4261
Practice Address - Country:US
Practice Address - Phone:858-335-3110
Practice Address - Fax:949-502-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care