Provider Demographics
NPI:1104354455
Name:AMBERS, ASHLEY (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:AMBERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2115 W 115TH ST
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-1901
Mailing Address - Country:US
Mailing Address - Phone:310-946-6100
Mailing Address - Fax:
Practice Address - Street 1:10458 CULVER BLVD
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-3469
Practice Address - Country:US
Practice Address - Phone:310-423-4766
Practice Address - Fax:310-423-0008
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant