Provider Demographics
NPI:1801493838
Name:ADLPARVAR, AMIRALI
Entity type:Individual
Prefix:
First Name:AMIRALI
Middle Name:
Last Name:ADLPARVAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 NICE DR APT 108
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-7213
Mailing Address - Country:US
Mailing Address - Phone:310-254-6682
Mailing Address - Fax:
Practice Address - Street 1:1960 NICE DR APT 108
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-7213
Practice Address - Country:US
Practice Address - Phone:310-254-6682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC18656171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty