MEDICARE: CELESTE LIM AMAYA MD MEDICAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	A68073	CA

General Provider Information

NPI Number	:	1437395357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CELESTE LIM AMAYA MD MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	74000 COUNTRY CLUB DR
Second Line	:	STE J-1
City	:	PALM DESERT
State	:	CA
Zip	:	92260-1685
Country	:	US
Telephone Number	:	760-346-7791
Fax Number	:	760-341-5953

Provider Business Practice Location Address
First Line	:	74000 COUNTRY CLUB DR
Second Line	:	STE J-1
City	:	PALM DESERT
State	:	CA
Zip	:	92260-1685
Country	:	US
Telephone Number	:	760-346-7791
Fax Number	:	760-341-5953

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CELESTE L AMAYA
Credential	:	MD
Telephone Number	:	760-346-7791

Provider Enumeration Date	:	12/23/2008
Last Update Date	:	02/04/2019

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