Provider Demographics
NPI:1942462320
Name:HELALI, AMIR NASR (MD)
Entity Type:Individual
Prefix:MR
First Name:AMIR
Middle Name:NASR
Last Name:HELALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:26445 VIA MALLORCA
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-9503
Mailing Address - Country:US
Mailing Address - Phone:831-261-9257
Mailing Address - Fax:
Practice Address - Street 1:10561 MERRITT ST
Practice Address - Street 2:
Practice Address - City:CASTROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95012-3310
Practice Address - Country:US
Practice Address - Phone:831-633-1514
Practice Address - Fax:831-633-0311
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT192623207Q00000X
CAA114648207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFK554ZMedicare UPIN