Amboseli Medical and Wellness Ctr

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

D0070195 Issued in MD

Legal business name

AMBOSELI MEDICAL AND WELLNESS CTR

Practice address

8320 Fenton Street Suite 122
Silver Spring, MD 20910

Phone

(301) 660-3035

NPI assigned

Nov 15, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Raphael Gaston Loutoby, MD

Title

Ceo

Phone

(301) 660-3035

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1942544887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 WISCONSIN AVE STE 600",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208153588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 FENTON STREET SUITE 122",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "20910",
            "telephone_number": "301-660-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBOSELI MEDICAL AND WELLNESS CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "LOUTOBY",
        "authorized_official_first_name": "RAPHAEL",
        "authorized_official_middle_name": "GASTON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-660-3035",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MD",
            "license": "D0070195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Amaro, DDS
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• Aaron Ament, M.D.

• Clinic/Center in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.