MEDICARE: AMAE HEALTH MEDICAL ASSOCIATES, PC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363LF0000X	Family Nurse Practitioner
2	1041C0700X	Clinical Social Worker
3	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1629796446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMAE HEALTH MEDICAL ASSOCIATES, PC

Provider Business Mailing Address
First Line	:	3033 DIVISADERO ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94123-3228
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11620 WILSHIRE BLVD STE 520
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1778
Country	:	US
Telephone Number	:	424-293-0031
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT AND CHIEF MEDICAL OFFICER
Name	:	SCOTT FEARS
Credential	:	MD
Telephone Number	:	213-399-4163

Provider Enumeration Date	:	08/17/2022
Last Update Date	:	01/06/2026

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1235017625 — SYNERGY: COMPREHENSIVE CARE FOR MIND, HEART, AND HOME
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