Provider Demographics
NPI:1750915260
Name:AMRUTA SAMARTH MD, INC
Entity type:Organization
Organization Name:AMRUTA SAMARTH MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AMRUTA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMARTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-378-4871
Mailing Address - Street 1:208 CALLE MARGUERITA
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1244
Mailing Address - Country:US
Mailing Address - Phone:949-378-4871
Mailing Address - Fax:
Practice Address - Street 1:15891 LOS GATOS ALMADEN RD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-3742
Practice Address - Country:US
Practice Address - Phone:949-378-4871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-24
Last Update Date:2020-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty