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Organization

AMA FOR HEALTH ADVANCEMENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SOPHIA SAEEDIAN KANGURLU M.D. (MEDICAL DIRECTOR)
(559) 312-8300
Entity
Organization

Contact information

Practice address
7969 N BLACKSTONE AVE # 176, FRESNO, CA 93720-4310
(559) 312-8300
(559) 298-7259
Mailing address
7969 N BLACKSTONE AVE # 176, FRESNO, CA 93720-4310
(559) 312-8300
(559) 298-7259

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A74483
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
A74483
CA
Enumeration date
09/26/2006
Last updated
06/13/2008
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