Provider Demographics
NPI:1285832717
Name:AMIR, ASAD (MD)
Entity Type:Individual
Prefix:
First Name:ASAD
Middle Name:
Last Name:AMIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 STERLING OAKS DR
Mailing Address - Street 2:APT # 145
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-9451
Mailing Address - Country:US
Mailing Address - Phone:201-753-2135
Mailing Address - Fax:
Practice Address - Street 1:300 HILLMONT AVE
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1651
Practice Address - Country:US
Practice Address - Phone:805-652-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1216732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1285832717Medicaid
CA1285832717Medicaid