# FORTANI MEDICAL CORP.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841579323
- **Authorized official:** DR. MARYAM FORTANI M.D. (PRESIDENT)
- **Authorized official phone:** (925) 202-1888

## Contact information

- **Practice address:** 13847 E 14TH ST, SUITE 216, SAN LEANDRO, CA 94578-2632
- **Practice address phone:** (510) 357-3023
- **Mailing address:** 3255 GULFSTREAM ST, PLEASANTON, CA 94588-3525

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | A 82319 | CA | Yes |

## Other

- **Enumeration date:** 08/15/2011
- **Last updated:** 03/05/2012