Provider Demographics
NPI:1831293109
Name:AMIN, ASHOKKUMAR I (MD)
Entity type:Individual
Prefix:
First Name:ASHOKKUMAR
Middle Name:I
Last Name:AMIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 W ORANGE AVE
Mailing Address - Street 2:STE #401
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804
Mailing Address - Country:US
Mailing Address - Phone:714-484-1200
Mailing Address - Fax:714-484-8807
Practice Address - Street 1:3010 W ORANGE AVE
Practice Address - Street 2:STE #401
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804
Practice Address - Country:US
Practice Address - Phone:714-484-1200
Practice Address - Fax:714-484-8807
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44111207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A44111Medicare ID - Type Unspecified
E09090Medicare UPIN