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General NPI Number Information
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NPI Number | 1518983899
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Entity Type | Individual
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Provider Name | AMIR K. GHIASSI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 04/09/2018
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Provider Practice Location Address
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Address Line | 1100 W STEWART DR
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City | ORANGE
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State | CA
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Zip | 92868-3849
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Country | US
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Telephone | 714-633-9111
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Fax |
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Provider Business Mailing Address
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Address Line | 24422 AVENIDA DE LA CARLOTA STE 275
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-3669
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Country | US
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Telephone | 949-829-8299
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Fax | 949-829-8298
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | C52272
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | C52272
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License Number State | CA
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