NPIMap

Individual provider Active NPI

Stanley G. Ambo, MD

  • Pediatrics Physician
  • Vista, CA
National Provider Identifier
1891735676
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G77814 Issued in CA
Practice address
2067 W. Vista Way
Suite 180
Vista, CA 92083-6033
Phone
(760) 945-3434
Fax
(760) 945-6761
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G77814 CA Primary

Addresses

Primary practice location

2067 W. Vista Way
Suite 180
Vista, CA 92083-6033

Mailing address

3860 Calle Fortunada
Suite 200
San Diego, CA 92123-4802
Phone (858) 636-4300

Other identifiers 1

IdentifierTypeStateIssuer
00G778140MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G77814CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Tri-City Hospital Past Accepting new patients
Rady Children'S Hospital San Diego Past Accepting new patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients
Scripps Health Past Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sambo43345@scrippshlth.medalliesdirect.net
  • Direct secure messaging: sambo105350@radychildrens.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1891735676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 CALLE FORTUNADA",
            "address_2": "SUITE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234802",
            "telephone_number": "858-636-4300",
            "fax_number": "858-836-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2067 W. VISTA WAY",
            "address_2": "SUITE 180",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836033",
            "telephone_number": "760-945-3434",
            "fax_number": "760-945-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBO",
        "first_name": "STANLEY",
        "middle_name": "G.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G77814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G778140",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.