Provider Demographics
NPI:1689169955
Name:AMPARO, MYRA-ASHLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:MYRA-ASHLEY
Middle Name:
Last Name:AMPARO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-5313
Mailing Address - Country:US
Mailing Address - Phone:408-262-7000
Mailing Address - Fax:408-262-7002
Practice Address - Street 1:182 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-5313
Practice Address - Country:US
Practice Address - Phone:408-262-7000
Practice Address - Fax:408-262-7002
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34251111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor