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NPI Code Detail

MEDICARE: DR. HARIKRISHNA AMBATI MD

MEDICARE:  DR. HARIKRISHNA  AMBATI  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianA193064CA

General Provider Information

NPI Number : 1154998730
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HARIKRISHNA AMBATI MD
Provider Business Mailing Address
First Line : 9067 SYCAMORE AVE BUILDING 6 UNIT 109
Second Line :
City : MONTCLAIR
State : CA
Zip : 91763
Country : US
Telephone Number : 408-571-9333
Fax Number :
Provider Business Practice Location Address
First Line : 5451 WALNUT AVE
Second Line :
City : CHINO
State : CA
Zip : 91710-2609
Country : US
Telephone Number : 909-464-8723
Fax Number : 909-464-8737
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2021
Last Update Date : 01/12/2026

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Directions to “ DR. HARIKRISHNA AMBATI MD” Practice Location

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