Individual provider Active NPI

Amal Isam Hamdan, FNP-C

  • Family Nurse Practitioner
  • Fullerton, CA
National Provider Identifier
1174091425
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95009938 Issued in CA
Practice address
731 S Highland Ave
Fullerton, CA 92832-2753
Phone
(714) 446-5100
NPI assigned
Nov 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95009938 CA Primary

Addresses

Primary practice location

731 S Highland Ave
Fullerton, CA 92832-2753

Mailing address

731 S Highland Ave
Fullerton, CA 92832-2753
Phone (714) 446-5100

Other names 1

  • Amal Isam Museitef Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95009938CAMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: ahamdan1374638@oc.providencedirect.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1174091425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 S HIGHLAND AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928322753",
            "telephone_number": "714-446-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 S HIGHLAND AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928322753",
            "telephone_number": "714-446-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMDAN",
        "first_name": "AMAL",
        "middle_name": "ISAM",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-05",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMAL",
            "last_name": "MUSEITEF",
            "middle_name": "ISAM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.