Neeta Ambe-Crain, M.D.

Individual provider Active NPI Specialist · Westlake Village, CA

NPI 1093832255 · NPPES record last updated Apr 3, 2012

Key facts

NPI
1093832255
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
License
G53593 (CA)
Practice address
1250 La Venta Dr Ste112
Westlake Village, CA 91361
Phone
(805) 371-0774
Fax
(805) 371-0773
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Opted out of Medicare
Yes, effective Oct 1, 2017 through Oct 1, 2027

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G53593CAMDSpecialist
53593CAMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G53593 CA Yes

Addresses

Primary practice location

1250 La Venta Dr Ste112
Westlake Village, CA 91361

Mailing address

1250 La Venta Dr Ste 112
Westlake Village, CA 91361-3756
Phone (805) 371-0774

Other providers in Westlake Village, CA

All providers in Westlake Village, CA · Specialist in California

Sources for this page

Verify at the official NPI Registry.