Provider Demographics
NPI:1265701163
Name:AMPL MANAGEMENT, INC
Entity type:Organization
Organization Name:AMPL MANAGEMENT, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:SORLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-870-4899
Mailing Address - Street 1:2855 TEMPLE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-2212
Mailing Address - Country:US
Mailing Address - Phone:562-254-5000
Mailing Address - Fax:949-522-5640
Practice Address - Street 1:2855 TEMPLE AVE STE A
Practice Address - Street 2:
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-2212
Practice Address - Country:US
Practice Address - Phone:949-870-4899
Practice Address - Fax:949-522-5640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA751542Medicare PIN