Provider Demographics
NPI:1376125815
Name:DO, AMY C
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:C
Last Name:DO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2529 S MADDOCK ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-5520
Mailing Address - Country:US
Mailing Address - Phone:657-900-6674
Mailing Address - Fax:
Practice Address - Street 1:8616 LA TIJERA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3945
Practice Address - Country:US
Practice Address - Phone:310-337-1550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-24
Last Update Date:2021-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator