Ellie R Amirova, DAOM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

18642 Issued in CA

Practice address

11340 Sir Francis Drake Dr
La Mesa, CA 91941-7268

Phone

(619) 669-8965

NPI assigned

Sep 4, 2019

Last updated

Sep 4, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1003464918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11340 SIR FRANCIS DRAKE DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919417268",
            "telephone_number": "619-669-8965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11340 SIR FRANCIS DRAKE DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919417268",
            "telephone_number": "619-669-8965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIROVA",
        "first_name": "ELLIE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DAOM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "18642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Url",
            "affiliation": "N",
            "endpointDescription": "Acupuncturist",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Acupuncturist",
            "address_1": "11340 Sir Francis Drake Dr",
            "city": "LA Mesa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "919417268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Acupuncturist in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.