Provider Demographics
NPI:1316203250
Name:HITESHI, AMIT KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:KUMAR
Last Name:HITESHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 COMPTON AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-7272
Mailing Address - Country:US
Mailing Address - Phone:951-493-0037
Mailing Address - Fax:
Practice Address - Street 1:2115 COMPTON AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-7272
Practice Address - Country:US
Practice Address - Phone:951-493-0037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA133696207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine