Provider Demographics
NPI:1245473131
Name:ALMULLAHASSANI, AMEER (MD)
Entity type:Individual
Prefix:DR
First Name:AMEER
Middle Name:
Last Name:ALMULLAHASSANI
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 1:1860 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-3590
Mailing Address - Country:US
Mailing Address - Phone:707-646-4380
Mailing Address - Fax:707-646-4381
Practice Address - Street 1:1860 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-3590
Practice Address - Country:US
Practice Address - Phone:707-646-4380
Practice Address - Fax:707-646-4381
Is Sole Proprietor?:No
Enumeration Date:2009-04-08
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-382852084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA25698004Medicare PIN