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Individual

JOY DIRHAM AMBRO

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
R.P.T.

Contact information

Practice address
24026 VISTA MONTANA, TORRANCE, CA 90505-6462
(310) 373-6226
(310) 373-6557
Mailing address
23109 FALENA AVE, TORRANCE, CA 90501-5618
(310) 373-6226
(310) 373-6557

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT14298
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OPT142980
BLUE SHIELD PROVIDER #
CA
01
PT14298
STATE LICENSE NUMBER
CA
Enumeration date
07/06/2005
Last updated
07/08/2007
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