Healthcare Provider Details

I. General information

NPI: 1588463590
Provider Name (Legal Business Name): MICHAEL AMAR RCP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 CHICAGO AVE STE D
RIVERSIDE CA
92507-2366
US

IV. Provider business mailing address

1845 CHICAGO AVE STE D
RIVERSIDE CA
92507-2366
US

V. Phone/Fax

Practice location:
  • Phone: 877-915-1556
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number36537
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: