Healthcare Provider Details

I. General information

NPI: 1821343948
Provider Name (Legal Business Name): AMBER D. GAITHER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2012
Last Update Date: 09/15/2023
Certification Date: 09/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 BARRANCA PKWY., STE. 170
IRVINE CA
92604
US

IV. Provider business mailing address

4050 BARRANCA PKWY., STE. 170
IRVINE CA
92604
US

V. Phone/Fax

Practice location:
  • Phone: 949-551-1090
  • Fax: 949-262-5500
Mailing address:
  • Phone: 949-551-1090
  • Fax: 949-262-5500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0116024734
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC186237
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: