Individual provider Active NPI

Dena Amr, MD

  • Surgery Physician
  • Los Alamitos, CA
National Provider Identifier
1710035746
Registry record updated May 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A78876 Issued in CA
Practice address
3791 Katella Ave. #201
Vascular & General Surgery Assoc
Los Alamitos, CA 90720
Phone
(562) 596-6736
Fax
(562) 596-5387
NPI assigned
Jan 8, 2007
Last updated
May 14, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A78876 CA Primary

Addresses

Primary practice location

3791 Katella Ave. #201
Vascular & General Surgery Assoc
Los Alamitos, CA 90720

Mailing address

3791 Katella Ave. #201
Vascular & General Surgery Assoc
Los Alamitos, CA 90720
Phone (562) 596-6736

Other identifiers 1

IdentifierTypeStateIssuer
A78876OtherCALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080730000855 CA Practitioner - General Surgery 6709950322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Wisconsin School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tam H Le MD IncGroup PAC ID 4284694126, 2 clinicians

Practice addresses (Care Compare)

18225 Brookhurst St
Suite 1
Fountain Valley, CA 92708-6719
Phone (714) 861-4560

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)16
Mastectomy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
78876CAMDClinical Social Worker
A78876CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tam H. Le, MD Inc. CurrentSince Aug 1, 2015 Accepting new patients
University of California Irvine Past Accepting new patients
Memorial Medical Group Inc Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients

Locations

18225 Brookhurst St
Ste 1
Fountain Vly, CA 92708
Phone (714) 861-4560

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273795200000",
    "number": "1710035746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3791 KATELLA AVE. #201",
            "address_2": "VASCULAR & GENERAL SURGERY ASSOC",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "90720",
            "telephone_number": "562-596-6736",
            "fax_number": "562-596-5387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3791 KATELLA AVE. #201",
            "address_2": "VASCULAR & GENERAL SURGERY ASSOC",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "90720",
            "telephone_number": "562-596-6736",
            "fax_number": "562-596-5387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMR",
        "first_name": "DENA",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2010-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A78876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A78876",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

Verify at the official NPI Registry.