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General NPI Number Information
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NPI Number | 1609923994
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Entity Type | Organization
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Legal Business Name | JOHN D AMAR MD INC
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 12370 HESPERIA RD SUITE 1
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City | VICTORVILLE
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State | CA
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Zip | 92395-4787
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Country | US
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Telephone | 760-245-8645
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Fax | 760-245-6798
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Provider Business Mailing Address
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Address Line | 12370 HESPERIA RD SUITE 1
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City | VICTORVILLE
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State | CA
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Zip | 92395-4787
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Country | US
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Telephone | 760-245-8645
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Fax | 760-245-6798
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Authorized Official
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Title or Position | CORP. SECRETARY
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Name | MRS. CARMELLA MARIA AMAR
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Credential |
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Telephone | 760-245-8645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State | CA
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