Basic Information
| Provider Information | |||||||||
| NPI: | 1407827660 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DARWIN | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | L | ||||||||
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| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 277 COHASSET RD | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959262242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308726650 | ||||||||
| FaxNumber: | 5308726653 | ||||||||
| Practice Location | |||||||||
| Address1: | 277 COHASSET RD | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308726650 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2006 | ||||||||
| LastUpdateDate: | 02/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | E4318 | AR | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A108093 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 158034001 | 05 | AR | MEDICAID |