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NPI Code Detail

MEDICARE: DR. AMANDIP BIRDI D.O.

MEDICARE: DR. AMANDIP BIRDI D.O.
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
1207Q00000XFamily Medicine Physician20A17672CA
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1639523772
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMANDIP BIRDI D.O.
Provider Business Mailing Address
First Line : PO BOX 35380
Second Line :
City : LAS VEGAS
State : NV
Zip : 89133-5380
Country : US
Telephone Number : 702-579-3203
Fax Number :
Provider Business Practice Location Address
First Line : 1300 E COOLEY DR
Second Line :
City : COLTON
State : CA
Zip : 92324-3905
Country : US
Telephone Number : 909-370-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2016
Last Update Date : 12/05/2025

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Directions to “ DR. AMANDIP BIRDI D.O.” Practice Location

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