Provider Demographics
NPI:1760654586
Name:BATH, AMARPREET (MD)
Entity Type:Individual
Prefix:
First Name:AMARPREET
Middle Name:
Last Name:BATH
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 1:7 ROCKY MTN
Mailing Address - Street 2:
Mailing Address - City:COTO DE CAZA
Mailing Address - State:CA
Mailing Address - Zip Code:92679-5226
Mailing Address - Country:US
Mailing Address - Phone:818-486-0365
Mailing Address - Fax:
Practice Address - Street 1:5901 E 7TH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90822
Practice Address - Country:US
Practice Address - Phone:562-826-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262871207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHGR7382661Medicare PIN