Healthcare Provider Details
I. General information
NPI: 1134564347
Provider Name (Legal Business Name): AMAR ARUN DESAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/01/2013
Last Update Date: 09/30/2020
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9209 COLIMA RD STE 1000
WHITTIER CA
90605-1813
US
IV. Provider business mailing address
12900 PARK PLAZA DR STE 150
CERRITOS CA
90703-9329
US
V. Phone/Fax
- Phone: 562-696-1104
- Fax: 562-696-2194
- Phone: 562-677-2409
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0011X |
| Taxonomy | Interventional Cardiology Physician |
| License Number | A132368 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | A132368 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: