Basic Information
| Provider Information | |||||||||
| NPI: | 1700406147 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JARED D. AMENT, MD, MPH, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7320 WOODLAKE AVE STE 215 | ||||||||
| Address2: | |||||||||
| City: | WEST HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913071401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008990101 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7320 WOODLAKE AVE STE 215 | ||||||||
| Address2: | |||||||||
| City: | WEST HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913071401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008990101 | ||||||||
| FaxNumber: | 3108708677 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2020 | ||||||||
| LastUpdateDate: | 04/24/2020 | ||||||||
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| AuthorizedOfficialLastName: | AMENT | ||||||||
| AuthorizedOfficialFirstName: | JARED | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6177214673 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD, MPH | ||||||||
| NPICertificationDate: | 04/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 1356653927 | 01 | PERSONAL NPI | OTHER |