Provider Demographics
NPI:1467585216
Name:AJAR, AMIR H (MD)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:H
Last Name:AJAR
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:PO BOX 3129
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90510-3129
Mailing Address - Country:US
Mailing Address - Phone:310-792-3914
Mailing Address - Fax:855-898-4055
Practice Address - Street 1:3655 LOMITA BLVD
Practice Address - Street 2:SUITE #308
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3934
Practice Address - Country:US
Practice Address - Phone:310-378-8787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA114730207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB233003OtherPTAN