MEDICARE: KAYLA AMBERT DC

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
1	111N00000X	Chiropractor	33474	CA

General Provider Information

NPI Number	:	1871173351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA AMBERT DC

Provider Business Mailing Address
First Line	:	4856 SANTA MONICA AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92107-2811
Country	:	US
Telephone Number	:	619-880-0051
Fax Number	:

Provider Business Practice Location Address
First Line	:	4856 SANTA MONICA AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92107-2811
Country	:	US
Telephone Number	:	619-880-0051
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2021
Last Update Date	:	04/09/2021

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Directions to “ KAYLA AMBERT DC” Practice Location

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