Healthcare Provider Details
I. General information
NPI: 1629915525
Provider Name (Legal Business Name): AMIR LAVAF MD INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1180 N INDIAN CANYON DR STE E218
PALM SPRINGS CA
92262-4885
US
IV. Provider business mailing address
75096 CITADEL PL
INDIAN WELLS CA
92210-8382
US
V. Phone/Fax
- Phone: 760-416-4770
- Fax: 760-416-4775
- Phone: 760-416-4770
- Fax: 760-416-4775
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
AMIR
LAVAF
Title or Position: OWNER
Credential: MD
Phone: 347-661-2485