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General NPI Number Information
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NPI Number | 1215724968
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Entity Type | Organization
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Legal Business Name | AMBULA DIAGNOSTICS LLC
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 4525 SHERMAN OAKS AVE STE 101
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-3826
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Country | US
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Telephone | 323-910-2461
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Fax |
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Provider Business Mailing Address
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Address Line | 13912 VENTURA BLVD
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-3510
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KHALIL JAMMAL
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Credential |
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Telephone | 323-910-2461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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