Provider Demographics
NPI:1174091425
Name:HAMDAN, AMAL ISAM (FNP-C)
Entity type:Individual
Prefix:
First Name:AMAL
Middle Name:ISAM
Last Name:HAMDAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:AMAL
Other - Middle Name:ISAM
Other - Last Name:MUSEITEF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:731 S HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-2753
Mailing Address - Country:US
Mailing Address - Phone:714-446-5100
Mailing Address - Fax:
Practice Address - Street 1:731 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-2753
Practice Address - Country:US
Practice Address - Phone:714-446-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95009938363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily