Healthcare Provider Details

I. General information

NPI: 1891752606
Provider Name (Legal Business Name): NAHIA J AMOURA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2210 E ILLINOIS AVE STE 408
FRESNO CA
93701-2184
US

IV. Provider business mailing address

2625 E DIVISADERO ST
FRESNO CA
93721-1431
US

V. Phone/Fax

Practice location:
  • Phone: 559-443-2694
  • Fax: 559-443-2696
Mailing address:
  • Phone: 559-443-2682
  • Fax: 559-443-2681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC197042
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: