Provider Demographics
NPI:1801831243
Name:DAMECOUR, CLAIRE (MD)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:DAMECOUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:
Other - Last Name:DAMECOUR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:21022 ANZA AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4249
Mailing Address - Country:US
Mailing Address - Phone:623-910-8975
Mailing Address - Fax:
Practice Address - Street 1:21022 ANZA AVE APT 202
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4249
Practice Address - Country:US
Practice Address - Phone:623-910-8975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC1343512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ74585Medicare ID - Type UnspecifiedMEDICARE
AZH01996Medicare UPIN