Healthcare Provider Details

I. General information

NPI: 1811359367
Provider Name (Legal Business Name): AMANDA JEAN MURPHY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3221
US

IV. Provider business mailing address

400 N PEPPER AVE STE 308
COLTON CA
92324-1801
US

V. Phone/Fax

Practice location:
  • Phone: 760-340-3911
  • Fax:
Mailing address:
  • Phone: 909-580-3360
  • Fax: 909-580-1363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberA195222
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number77416
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: