Provider Demographics
NPI:1720337306
Name:AMORNKUL, PAULI (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULI
Middle Name:
Last Name:AMORNKUL
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 1:50 BEALE STREET
Mailing Address - Street 2:SUITE 1300, IAVI-CAPS
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105
Mailing Address - Country:US
Mailing Address - Phone:646-577-9589
Mailing Address - Fax:415-597-9327
Practice Address - Street 1:50 BEALE STREET
Practice Address - Street 2:SUITE 1300, IAVI-CAPS
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105
Practice Address - Country:US
Practice Address - Phone:646-577-9589
Practice Address - Fax:415-597-9327
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ231851207Q00000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine