Provider Demographics
NPI:1265497093
Name:AMBERG, JAMES MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:AMBERG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5525 GROSSMONT CENTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3009
Mailing Address - Country:US
Mailing Address - Phone:619-644-6500
Mailing Address - Fax:619-644-6539
Practice Address - Street 1:5525 GROSSMONT CENTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3009
Practice Address - Country:US
Practice Address - Phone:619-644-6500
Practice Address - Fax:619-644-6539
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2014-02-28
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Provider Licenses
StateLicense IDTaxonomies
CAG048686207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A51144Medicare UPIN