Individual
AMIN SEYEDKAZEMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3132 W MARCH LN STE 5, STOCKTON, CA 95219-2354
(209) 475-5500
(209) 475-5535
Mailing address
3400 DATA DR, ATTN CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20A18367
CA
Other
Enumeration date
04/03/2017
Last updated
08/17/2020
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