Individual
AMANDA NICOLE BISHARAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23929 MCBEAN PKWY STE 215, VALENCIA, CA 91355-4468
(661) 799-2542
Mailing address
3401 N OSAGE AVE, CHICAGO, IL 60634-2954
(773) 803-6023
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA56005
CA
Other
Enumeration date
01/19/2019
Last updated
12/17/2024
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