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MARIAM AMIRI NPI 1235140336


NPI Information

NPI: 1235140336
Provider Name: MARIAM AMIRI

Doing Business As: LOMA LINDA FOOT AND ANKLE CENTER

Classification: Podiatrist - 213E00000X
Entity Type: Organization

CLIA Number: 05D2098658

Address:
18225 OUTER HIGHWAY 18
APPLE VALLEY, CA
ZIP 92307
Phone: (760) 242-5096
Get Directions

MARIAM AMIRI is a podiatrist in Apple Valley, CA. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. MARIAM AMIRI NPI is 1235140336. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Loma Linda Foot And Ankle Center.

The provider's business location address is:

18225 OUTER HIGHWAY 18
APPLE VALLEY, CA
ZIP 92307
Phone: (760) 242-5096
Fax: (909) 242-3814

The provider's authorized official is Mariam S Amiri .
The authorized official title is Owner and has the following contact phone number (909) 796-3707.

The CLIA number assigned to this NPI record is 05D2098658 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/11/2006 and was last updated on 6/17/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213E00000XPodiatristE4049CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GRE001751MEDICAIDCALIFORNIA
2ZZZ22455ZMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAPROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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