Provider Demographics
NPI:1477516706
Name:CHILINGIRIAN, AMY VICTORIA (DO)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:VICTORIA
Last Name:CHILINGIRIAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10243 GENETIC CENTER DR.
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-4427
Mailing Address - Country:US
Mailing Address - Phone:858-499-2600
Mailing Address - Fax:858-526-6083
Practice Address - Street 1:10243 GENETIC CENTER DR.
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-4427
Practice Address - Country:US
Practice Address - Phone:858-499-2600
Practice Address - Fax:858-526-6083
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8522207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ968076Medicaid
AZ968076Medicaid
AZ104962Medicare ID - Type Unspecified