Provider Demographics
NPI:1699985747
Name:AMBROSE, JOSIAH BARTLETT (MD)
Entity type:Individual
Prefix:DR
First Name:JOSIAH
Middle Name:BARTLETT
Last Name:AMBROSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 ROLLING HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-4322
Mailing Address - Country:US
Mailing Address - Phone:646-265-4572
Mailing Address - Fax:
Practice Address - Street 1:UCSF DEPT OF NEUROLOGY
Practice Address - Street 2:505 PARNASSUS, BOX 0114
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0001
Practice Address - Country:US
Practice Address - Phone:415-353-3549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA995172084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology