Provider Demographics
NPI:1811184237
Name:AMOOIE, ADRIAN A (MD)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:A
Last Name:AMOOIE
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 1:5701 S EASTERN AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:CA
Mailing Address - Zip Code:90040-2973
Mailing Address - Country:US
Mailing Address - Phone:323-914-5311
Mailing Address - Fax:
Practice Address - Street 1:5701 S EASTERN AVE FL 5
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90040-2973
Practice Address - Country:US
Practice Address - Phone:323-914-5311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-30
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101428207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine