Basic Information
| Provider Information | |||||||||
| NPI: | 1508024852 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAVAF | ||||||||
| FirstName: | AMIR | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 51753 EL DORADO DR | ||||||||
| Address2: | |||||||||
| City: | LA QUINTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922539034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7606192309 | ||||||||
| FaxNumber: | 8664280708 | ||||||||
| Practice Location | |||||||||
| Address1: | 1180 N INDIAN CANYON DR | ||||||||
| Address2: | STE E218 | ||||||||
| City: | PALM SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922624800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7604164770 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2008 | ||||||||
| LastUpdateDate: | 07/02/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | A 115056 | CA | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
No ID Information.