Provider Demographics
NPI:1902959240
Name:ARMENTA, AMALIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:AMALIA
Middle Name:A
Last Name:ARMENTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMALIA
Other - Middle Name:A
Other - Last Name:ARMENTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD APC
Mailing Address - Street 1:3600 N VERDUGO RD, STE 301
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208
Mailing Address - Country:US
Mailing Address - Phone:818-952-3075
Mailing Address - Fax:818-952-5572
Practice Address - Street 1:3600 N VERDUGO RD, STE 301
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208
Practice Address - Country:US
Practice Address - Phone:818-952-3075
Practice Address - Fax:818-952-5572
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80646207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOSD1060948OtherDEPT OF PUBLIC HEALTH
I02888Medicare UPIN
CAA80646Medicare PIN