Healthcare Provider Details

I. General information

NPI: 1629796446
Provider Name (Legal Business Name): AMAE HEALTH MEDICAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2022
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11620 WILSHIRE BLVD STE 520
LOS ANGELES CA
90025-1778
US

IV. Provider business mailing address

3033 DIVISADERO ST
SAN FRANCISCO CA
94123-3228
US

V. Phone/Fax

Practice location:
  • Phone: 424-293-0031
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SCOTT FEARS
Title or Position: PRESIDENT AND CHIEF MEDICAL OFFICER
Credential: MD
Phone: 213-399-4163