Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC18301 | CA |
N | 111NI0013X | Independent Medical Examiner | DC18301 | CA |
N | 111NN0400X | Neurology | DC18301 | CA |
N | 111NN1001X | Nutrition | DC18301 | CA |
N | 111NR0400X | Rehabilitation Chiropractor | DC18301 | CA |
N | 111NS0005X | Chiropractic Sports Physician | DC18301 | CA |
N | 111NX0100X | Occupational Health | DC18301 | CA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | DC18301 | CA |
Y | 363L00000X | Nurse Practitioner | NP95013795 | CA |
N | 363LA2200X | Nurse Practitioner - Adult Health | NP95013795 | CA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | NP95013795 | CA |
N | 363LP2300X | Nurse Practitioner - Primary Care | NP95013795 | CA |
N | 363LX0106X | Nurse Practitioner - Occupational Health | NP95013795 | CA |
NPI | 1194940809 |
---|---|
Provider Name | Dr. Joseph R. Ambrose |
First Address | El Dorado Hills, CA 95762-3927 |
Second Address | El Dorado Hills, CA 95762-3765 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 10/02/2020 |