Provider Demographics
NPI:1982790598
Name:AMIR, MICHAL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAL
Middle Name:
Last Name:AMIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8641 WILSHIRE BLVD
Mailing Address - Street 2:SUITE #215
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2900
Mailing Address - Country:US
Mailing Address - Phone:310-289-0330
Mailing Address - Fax:310-289-5910
Practice Address - Street 1:8641 WILSHIRE BLVD
Practice Address - Street 2:SUITE #215
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2900
Practice Address - Country:US
Practice Address - Phone:310-289-0330
Practice Address - Fax:310-289-5910
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG78967207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG29024Medicare UPIN