Individual
ROHIN AMBARAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
19100 VENTURA BLVD STE 3, TARZANA, CA 91356-3234
(916) 517-3481
Mailing address
18 AUTUMN LEAF DR, THOUSAND OAKS, CA 91360-2607
(916) 517-3481
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
100021
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
MI
Other
Enumeration date
04/09/2015
Last updated
06/28/2021
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