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NPI Code Detail

MEDICARE: AMANDA NAGUIAT FERNANDEZ M.D.

MEDICARE: AMANDA NAGUIAT FERNANDEZ M.D.
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
12084N0402XNeurology with Special Qualifications in Child Neurology PhysicianC50398CA

General Provider Information

NPI Number : 1770551350
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA NAGUIAT FERNANDEZ M.D.
Provider Business Mailing Address
First Line : 455 S MAIN ST
Second Line :
City : ORANGE
State : CA
Zip : 92868-3835
Country : US
Telephone Number : 714-532-7555
Fax Number : 714-532-7953
Provider Business Practice Location Address
First Line : 455 S MAIN ST
Second Line :
City : ORANGE
State : CA
Zip : 92868-3835
Country : US
Telephone Number : 714-532-7555
Fax Number : 714-532-7953
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2006
Last Update Date : 03/16/2012

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