Provider Demographics
NPI:1770679722
Name:MANN, MALI AMIRSOLEIMANI (MD)
Entity Type:Individual
Prefix:
First Name:MALI
Middle Name:AMIRSOLEIMANI
Last Name:MANN
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 1:701 WELCH ROAD
Mailing Address - Street 2:215
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304
Mailing Address - Country:US
Mailing Address - Phone:650-325-8762
Mailing Address - Fax:650-325-4095
Practice Address - Street 1:701 WELCH ROAD
Practice Address - Street 2:215
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304
Practice Address - Country:US
Practice Address - Phone:650-325-8762
Practice Address - Fax:650-325-4095
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A3538902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry