Individual
DR. AMANDA M DEL RE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A129568
CA
390200000X
Student in an Organized Health Care Education/Training Program
0116021659
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A129568
STATE LICENSE
CA
Enumeration date
07/07/2009
Last updated
12/29/2016
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