Provider Demographics
NPI:1063029833
Name:KAMAL, KAMAR
Entity Type:Individual
Prefix:
First Name:KAMAR
Middle Name:
Last Name:KAMAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMOURA
Other - Middle Name:
Other - Last Name:KAMAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5 RIVERSTONE
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-5309
Mailing Address - Country:US
Mailing Address - Phone:949-350-3683
Mailing Address - Fax:
Practice Address - Street 1:5 RIVERSTONE
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-5309
Practice Address - Country:US
Practice Address - Phone:949-350-3683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator