Basic Information
| Provider Information | |||||||||
| NPI: | 1043376049 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AMBURGEY | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | GUTSHALL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2100 POWELL ST STE 900 | ||||||||
| Address2: | |||||||||
| City: | EMERYVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946081844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5103502600 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 815 POLLARD RD | ||||||||
| Address2: | |||||||||
| City: | LOS GATOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950321438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4083786131 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2006 | ||||||||
| LastUpdateDate: | 03/13/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 2006-01738 | NC | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | C141538 | CA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.