Provider Demographics
NPI:1366601072
Name:AMBE-AMOA, HELEN PAMELA (RPH)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:PAMELA
Last Name:AMBE-AMOA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3802 CULVER CTR
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-3303
Mailing Address - Country:US
Mailing Address - Phone:310-837-2122
Mailing Address - Fax:310-838-2618
Practice Address - Street 1:3802 CULVER CTR
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-3303
Practice Address - Country:US
Practice Address - Phone:310-837-2122
Practice Address - Fax:310-838-2618
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist