Provider Demographics
NPI:1740593664
Name:LLOYD, AMANDA A (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:A
Last Name:LLOYD
Suffix:
Gender:F
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 1134
Mailing Address - Street 2:
Mailing Address - City:CARDIFF
Mailing Address - State:CA
Mailing Address - Zip Code:92007-7134
Mailing Address - Country:US
Mailing Address - Phone:760-452-2080
Mailing Address - Fax:
Practice Address - Street 1:477 N EL CAMINO REAL
Practice Address - Street 2:SUITE D304
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1328
Practice Address - Country:US
Practice Address - Phone:760-452-2080
Practice Address - Fax:760-230-2927
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2019-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.057761207R00000X
CAA123852207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB219003Medicare PIN