Provider Demographics
NPI:1467880229
Name:MORYL, AMBER BETH (MS, MPAS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:BETH
Last Name:MORYL
Suffix:
Gender:F
Credentials:MS, MPAS, PA-C
Other - Prefix:MISS
Other - First Name:AMBER
Other - Middle Name:BETH
Other - Last Name:RIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, MPAS, PA-C
Mailing Address - Street 1:5253 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-4151
Mailing Address - Country:US
Mailing Address - Phone:909-464-2845
Mailing Address - Fax:
Practice Address - Street 1:5253 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-4151
Practice Address - Country:US
Practice Address - Phone:909-464-2845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-14
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA23272363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant