Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 20A10917 | CA |
NPI | 1215193495 |
---|---|
Provider Name | Kevin E. Amaya |
First Address | Harbor City, CA 90710-3416 |
Second Address | Harbor City, CA 90710-3416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2008 |
Last Update Date | 20/10/2021 |