Provider Demographics
NPI:1831121375
Name:AMEN, DANIEL GREGORY (MD)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:GREGORY
Last Name:AMEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:959 SOUTH COAST DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626
Mailing Address - Country:US
Mailing Address - Phone:949-266-3700
Mailing Address - Fax:949-236-8694
Practice Address - Street 1:959 SOUTH COAST DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626
Practice Address - Country:US
Practice Address - Phone:949-266-3700
Practice Address - Fax:949-266-3780
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2024-03-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2197822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry