Provider Demographics
NPI:1508390972
Name:QAYUM, AMINA (MD)
Entity type:Individual
Prefix:DR
First Name:AMINA
Middle Name:
Last Name:QAYUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7290 EDINGER AVE UNIT 3103
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-0939
Mailing Address - Country:US
Mailing Address - Phone:314-757-2251
Mailing Address - Fax:
Practice Address - Street 1:7290 EDINGER AVE UNIT 3103
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-0939
Practice Address - Country:US
Practice Address - Phone:314-757-2251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1718132080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine