MEDICARE: NAVIN PURUSHOTTAM AMIN 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
1	207Y00000X	Otolaryngology Physician	A33173	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00002598	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851390314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAVIN PURUSHOTTAM AMIN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 5971
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92863-5971
Country	:	US
Telephone Number	:	714-571-5000
Fax Number	:	714-571-5055

Provider Business Practice Location Address
First Line	:	1140 W LA VETA AVE
Second Line	:	STE. 520
City	:	ORANGE
State	:	CA
Zip	:	92868-4225
Country	:	US
Telephone Number	:	714-953-6928
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	12/17/2007

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