Provider Demographics
NPI:1083000244
Name:DENA AMR MD INC
Entity Type:Organization
Organization Name:DENA AMR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMR
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:949-631-3454
Mailing Address - Street 1:5 HOLLAND
Mailing Address - Street 2:SUITE 101
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2566
Mailing Address - Country:US
Mailing Address - Phone:949-588-2190
Mailing Address - Fax:949-588-2199
Practice Address - Street 1:1501 SUPERIOR AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3600
Practice Address - Country:US
Practice Address - Phone:949-631-3454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-14
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty