Provider Demographics
NPI:1891752606
Name:AMOURA, NAHIA J (MD)
Entity type:Individual
Prefix:
First Name:NAHIA
Middle Name:J
Last Name:AMOURA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2625 E DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1431
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:2210 E ILLINOIS AVE STE 408
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2184
Practice Address - Country:US
Practice Address - Phone:559-443-2694
Practice Address - Fax:559-443-2696
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2024-09-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC197042207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47078557540Medicaid
NEH00063Medicare UPIN
NE47078557540Medicaid