Provider Demographics
NPI:1679392070
Name:AMALI
Entity type:Organization
Organization Name:AMALI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO & GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:AMEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPOSITO
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:619-837-2072
Mailing Address - Street 1:826 ORANGE AVENUE
Mailing Address - Street 2:PMB 508
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118
Mailing Address - Country:US
Mailing Address - Phone:619-837-2072
Mailing Address - Fax:
Practice Address - Street 1:432 HOTZ ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-5709
Practice Address - Country:US
Practice Address - Phone:619-837-2072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMALI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-03
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty