JOHN D AMAR MD INC

Provider Demographics

• NPI: 1609923994
• Name: JOHN D AMAR MD INC
• Entity Type: Organization
• Organization Name: JOHN D AMAR MD INC
• Other - Org Name: AMAR MEDICAL ASSOCIATES
• Other - Org Type: Doing Business As
• Authorized Official - Title/Position: CORP. SECRETARY
• Authorized Official - Prefix: MRS
• Authorized Official - First Name: CARMELLA
• Authorized Official - Middle Name: MARIA
• Authorized Official - Last Name: AMAR
• Authorized Official - Phone: 760-245-8645
• Mailing Address - Street 1: 12370 HESPERIA RD
• Mailing Address - Street 2: SUITE 1
• Mailing Address - City: VICTORVILLE
• Mailing Address - State: CA
• Mailing Address - Zip Code: 92395-4787
• Mailing Address - Country: US
• Mailing Address - Phone: 760-245-8645
• Mailing Address - Fax: 760-245-6798
• Practice Address - Street 1: 12370 HESPERIA RD
• Practice Address - Street 2: SUITE 1
• Practice Address - City: VICTORVILLE
• Practice Address - State: CA
• Practice Address - Zip Code: 92395-4787
• Practice Address - Country: US
• Practice Address - Phone: 760-245-8645
• Practice Address - Fax: 760-245-6798
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-01-05
• Last Update Date: 2023-03-07

Provider Licenses

State	License ID	Taxonomies
CA		207Y00000X, 208600000X, 231H00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207Y00000X	Allopathic & Osteopathic Physicians	Otolaryngology		Group - Multi-Specialty
No	208600000X	Allopathic & Osteopathic Physicians	Surgery		Group - Multi-Specialty
No	231H00000X	Speech, Language and Hearing Service Providers	Audiologist		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
CA	GY395Z	Other	STEVEN REICHENBACH, AUD PTAN#
CA	ZZZ37372Z	Other	BLUE SHIELD PROV ID
CA	1255347480	Other	STEVEN REICHENBACH AU.D. IND NPI#
CA	1609923994	Other	GROUP NPI
CA	1912975772	Other	AMAR IND NPI #
CA	1689752867	Other	LEAZURE IND NPI#
CA	756041862	Other	MEDICARE RAILROAD
CA	756041862	Other	MEDICARE RAILROAD
CA	ZZZ37372Z	Other	BLUE SHIELD PROV ID
CA	1255347480	Other	STEVEN REICHENBACH AU.D. IND NPI#