Provider Demographics
NPI:1679670327
Name:WITMAN, AMY B (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:B
Last Name:WITMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:12395 EL CAMINO REAL STE 115
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-3083
Mailing Address - Country:US
Mailing Address - Phone:858-724-1313
Mailing Address - Fax:858-724-1314
Practice Address - Street 1:12395 EL CAMINO REAL STE 115
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-3083
Practice Address - Country:US
Practice Address - Phone:858-724-1313
Practice Address - Fax:858-724-1314
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2020-01-14
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Provider Licenses
StateLicense IDTaxonomies
CAG77904207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG12768Medicare UPIN