Healthcare Provider Details

I. General information

NPI: 1679670764
Provider Name (Legal Business Name): AMEN NESS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL # FE16
MADERA CA
93636-8761
US

IV. Provider business mailing address

57 RIVER EDGE FARMS RD
MADISON CT
06443-2711
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-6700
  • Fax:
Mailing address:
  • Phone: 831-524-0035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number208773
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberG49848
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number0101281969
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number25MA09030000
License Number StateNJ
# 5
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberV0485
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: