Provider Demographics
NPI:1497746598
Name:AMMAR, SHERIF M (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERIF
Middle Name:M
Last Name:AMMAR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:70 PALATINE
Mailing Address - Street 2:UNIT 320
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-7661
Mailing Address - Country:US
Mailing Address - Phone:201-725-0138
Mailing Address - Fax:951-353-5722
Practice Address - Street 1:10800 MAGNOLIA AVE
Practice Address - Street 2:MOB-2, 5TH FLOOR, HEAD AND NECK SURGERY
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3043
Practice Address - Country:US
Practice Address - Phone:951-353-5681
Practice Address - Fax:951-353-5722
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2021-11-29
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Provider Licenses
StateLicense IDTaxonomies
MA224198207Y00000X
CAC52571207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2107902Medicaid
MA2107902Medicaid
MAJ29092Medicare ID - Type Unspecified