Provider Demographics
NPI:1831114842
Name:KAMALI, HENRY (MD)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:KAMALI
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 1:15466 LOS GATOS BLVD STE 109-297
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2542
Mailing Address - Country:US
Mailing Address - Phone:408-438-0424
Mailing Address - Fax:408-354-0633
Practice Address - Street 1:718 UNIVERSITY AVE STE 211
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-7608
Practice Address - Country:US
Practice Address - Phone:408-438-0424
Practice Address - Fax:408-354-0633
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68106207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A681060Medicaid
CA00A681060Medicaid
H53382Medicare UPIN