Healthcare Provider Details

I. General information

NPI: 1174238927
Provider Name (Legal Business Name): AMBER MOHSIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2023
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5565 GROSSMONT CENTER DR STE 256
LA MESA CA
91942-3098
US

IV. Provider business mailing address

10049 MARION AVE
MONTCLAIR CA
91763-3227
US

V. Phone/Fax

Practice location:
  • Phone: 619-462-3131
  • Fax: 619-462-1731
Mailing address:
  • Phone: 909-615-3533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: