Healthcare Provider Details

I. General information

NPI: 1851505531
Provider Name (Legal Business Name): AMY DEWAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 06/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 W MISSION AVE SUITE 103
ESCONDIDO CA
92025-1720
US

IV. Provider business mailing address

125 W MISSION AVE SUITE 103
ESCONDIDO CA
92025-1720
US

V. Phone/Fax

Practice location:
  • Phone: 760-747-3424
  • Fax: 760-747-3435
Mailing address:
  • Phone: 760-747-3424
  • Fax: 760-747-3435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA97621
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: