Provider Demographics
NPI:1962723338
Name:BEGNOCHE, AMY C (DO)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:C
Last Name:BEGNOCHE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N. PEPPER AVE
Mailing Address - Street 2:EMERGENCY MEDICINE DEPT.
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324
Mailing Address - Country:US
Mailing Address - Phone:909-580-6370
Mailing Address - Fax:
Practice Address - Street 1:400 N PEPPER AVE
Practice Address - Street 2:EMERGENCY MEDICINE DEPT.
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-1801
Practice Address - Country:US
Practice Address - Phone:909-580-6370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-19
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12025207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine