Amir Ettekal, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A91433 Issued in CA

Practice address

1200 Artesia Blvd Ste 204
Hermosa Beach, CA 90254-2755

Phone

(310) 281-3365

NPI assigned

Mar 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1982728127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 ARTESIA BLVD STE 204",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542755",
            "telephone_number": "310-281-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ARTESIA BLVD STE 204",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542755",
            "telephone_number": "310-281-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTEKAL",
        "first_name": "AMIR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A91433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Marlen Elminoufi, LAC.
• Endeavour Psychology Group
• Tracie Alexandra Endelson, L.AC.
• Evelyn Michelle Escobar
• Abraham Estess, DDS
• Evolving Pathways Psychology Corporation
• Claudia Faggouseh, M.S., LMFT
• Marcus Kyle Carlos Fajardo
• Haley Falzon, LMFT
• Julie Fanelli, ASW

• Psychiatry Physician in Hermosa Beach, CA
• Providers in Hermosa Beach, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.