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Individual

AMMAR ISTWANI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1045 ATLANTIC AVE, SUITE 105, LONG BEACH, CA 90813
(562) 491-9167
(562) 491-7969
Mailing address
1045 ATLANTIC AVE, SUITE 105, LONG BEACH, CA 90813-3408
(562) 491-9167
(562) 491-7969

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
G80027
CA
2085R0202X
Diagnostic Radiology Physician
Primary
G80027
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G800270
BCBS
CA
05
00G800270
CA
01
HW8412
GROUP PTAN
CA
01
HW8412A
PTAN/LEGACY PACIFIC HOSP
CA
01
HW8412B
PTAN/LEGACY COMMUNITY HOSP
CA
01
HW881
ST MARYS PTAN
CA
01
P00479357
RR MEDICARE
CA
Enumeration date
06/06/2006
Last updated
08/20/2018
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