MEDICARE: ANTONIO RAGAY AMOR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	200100999	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1292V	OTHER	NC	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1205868262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTONIO RAGAY AMOR M.D.

Provider Business Mailing Address
First Line	:	3559 E SOUTH ST STE B
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-4519
Country	:	US
Telephone Number	:	704-366-7584
Fax Number	:	704-364-2417

Provider Business Practice Location Address
First Line	:	3559 E SOUTH ST STE B
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-4519
Country	:	US
Telephone Number	:	704-366-7584
Fax Number	:	704-364-2417

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	03/14/2019

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